Celebrating the first International Paramedics Day
A reflection from Adrian South, Paramedic & Deputy Director of Clinical Care.
The College of Paramedics has launched the first International Paramedics Day, taking place this Friday 8 July 2022. The day is an opportunity for everyone to reflect on the amazing work of paramedics and the difference they make to patients every single day.
Personally, the day has made me think about just how much the profession has progressed in just the past 20 years. I remember sitting in a national ambulance conference in 2000 as a student on one of the first university programmes, listening to a debate on whether paramedics needed degrees. "Paramedics don’t need to diagnose. Tell me, how will a degree help you follow a protocol on the way to hospital?’"
At that point the profession wasn’t registered and the accepted wisdom was that the blue book – a large binder of national training – would tell you all that you could possibly need to know. On my first day working for Dorset Ambulance Service in 2001, I was presented with my protocol folder. It contained 34 one page protocols, detailing the treatment of common conditions and the administration of a small range of medicines. How you actually reached the diagnosis to know which protocol to follow remained a mystery...
I remember the first change I ever made to paramedic practice in 2004. Challenging why so many patients were cannulated and why paramedics generally used a large bore cannula. There was no answer and little evidence. However, what was known, was that only paramedics ‘who couldn’t cannulate’ used a blue/pink on an adult. Practice changed, with pink now the most frequently used size. It was a little win, but it showed me that paramedics could affect change.
At that point whilst paramedics could advise on potential developments, only the Medical Advisory Group, a voluntary group of local hospital doctors, had the authority to agree changes. I became a regular attendee of the meeting and often joked that I felt like Oliver going in with my bowl to beg for more small changes. Today, working as part of a multi-professional senior team including nurses, doctors and pharmacists, paramedics are quite rightly at the forefront of driving their profession.
One of the greatest changes has been the move to treat patients at home. It’s hard to believe that this approach was only formalised in 2010 with the launch of the Right Care programme. I remember first discussing the idea in 2006 and firmly being told that ‘it’s quicker to take a patient to hospital than faff on scene pretending to be a doctor. Non-conveyance simply won’t work’. We now see and treat 32.8% of patients on-scene. Non-conveyance drove so many of the changes we take for granted. Paramedics became autonomous. We were supported to actually diagnose and we started to access community pathways. Simplistic protocols developed into the comprehensive guidance that we have today to support our clinicians.
Just 20 years ago, career progression was limited to remaining a paramedic, becoming a manager or leaving the road to be a training officer. Roles for paramedics did not exist outside of ambulance services. Today, there have never been so many opportunities for paramedics and paramedics have never been so much in demand. Within ambulance services, roles now vary widely from telephone triage to research to urgent care to critical care. Paramedic prescribing and advanced/consultant level clinical posts are particularly exciting developments, allowing paramedics to develop to their full clinical potential, in ways that we simply could not have dreamed of even a decade ago. The College of Paramedics' ‘Not All Paramedics Wear Green’ campaign was a reminder of just how many different roles are now available to paramedics outside of ambulance services.
The pace of transformation of the profession from the days of conveyance to hospital with basic protocols, to autonomous clinicians able to work in literally hundreds of different roles, using advanced skills, is unprecedented. As Paramedics we should be proud of where we have come from and focus on the difference that every one of us can make to our profession in the years to come. As ever, I’m incredibly proud of the work that our thousands of paramedics do in roles across the Trust and I'd like to also thank colleagues from across the wide range of other professions that work within SWASFT, for the care they tirelessly provide to our patients.