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Concerns over increasing use of junior ambulance staff in Buckinghamshire
CONCERNS have been raised about the increasing use of junior ambulance staff in Buckinghamshire – meaning some 999 calls are not attended by a qualified paramedic.
South Central Ambulance Service now employs more Emergency Care Assistants [ECAs] in Bucks than it does paramedics – prompting fears that ambulance crews may not include the skill and experience levels expected by patients.
ECAs, whose starting salary is £16,000, only have basic levels of medical training and cannot administer drugs or give injections.
Their role is primarily to support a qualified clinician such as a paramedic – though South Central Ambulance Service [SCAS] is regularly making use of ECA-only crews to attend non-emergency calls such as hospital transfers.
What has prompted concern is these crews, called Dual ECAs, can also provide emergency deployment or cover in "exceptional circumstances" – which could involve acting as a first response in serious cases such as heart attacks or breathing difficulties.
The Association of Professional Ambulance Personnel, the ambulance workers' union, says ECAs should be used on less serious call-outs or to back up clinical staff.
But it says "the waters are being muddied and they’ve ended up doing more high priority calls where there’s a limitation of resources."
Meanwhile, Katherine Murphy, chief executive of The Patients Association, said: "The increasing use of Emergency Care Assistants is of real concern – the quality of that initial assessment of a patient’s condition when an ambulance is called out can be a matter of life or death.
"This is indicative of the choices that are being forced on the NHS as a result of the Government’s drive to save £20 billion from the NHS budget."
Five other ambulance trusts reportedly insist on their response teams including at least one paramedic or ambulance technician - who both have a higher level of clinical training.
A spokesman for the West Midlands Ambulance Service told the Bucks Free Press it was phasing out ECAs as the system "doesn’t work for us".
It is training them to become technicians, who earn upwards of about £18,000, or paramedics, who start on about £21,000.
Ambulances in Buckinghamshire have struggled to meet response-time targets, and with demand for services increasing, the number of ECAs in Buckinghamshire has risen by 15 [from 62 to 77] over the last three years.
The number of technicians is up by eight [to 95] over the same period, but there are three fewer paramedics [down to 69].
Meanwhile, a Freedom of Information request by the Bucks Free Press showed that over a five-month period this year, more than 170 ambulance call-outs in Bucks were attended solely by ECAs - without a technician or paramedic attending at any point.
James Keating-Wilkes, spokesman for South Central Ambulance Service, said some of these incidents will have been 999 calls, but others would have been routine jobs such as hospital transfers.
SCAS has had problems recruiting qualified paramedic staff, but should be in a position to employ a large number of new graduates later this year, he added.
He stressed that Dual ECA crews are not normally used for emergency calls – but generally deployed for work that does not require the skills of a paramedic or technician.
He added: "If an emergency call arises at a location where our nearest available resource is a Dual ECA crew, then of course we would mobilise that crew to that incident in order to get as quick a response as possible to the patient, whilst also immediately sending a clinically qualified back up resource...
"It is absolutely correct that we should mobilise that crew, whilst also immediately mobilising a paramedic or technician back up.
"Dual ECA staff have very good training in immediate care and basic life support - and every piece of evidence indicates that it is the early intervention of CPR and early defibrillation that actually saves lives - so getting someone trained in CPR and the use of a defibrillator quickly to the scene is vital in saving life following cardiac arrest."
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