Paramedic: Salary and job description

Paramedics provide an immediate response to emergency calls that can be both traumatic and medical in origin, and respond to GP referrals and 111 calls

As a paramedic, you'll usually be the first senior autonomous independent healthcare professional on the scene, and the level of care you provide can range from dealing with life-threatening conditions to minor illnesses and injuries.

You'll need to undertake a full medical and health assessment to determine a patient's condition, provide essential treatment and, when necessary, transport to a designated hospital or care facility.

You'll often work in a two-person ambulance crew alongside an ambulance technician or emergency care assistant, or alone using an emergency response car, motorbike or bicycle to get to a patient.

The profession has developed to become a provider of mobile healthcare, meaning that you can also work in a wider range of settings, including doctors' surgeries, minor injury units, walk-in centres and A&E departments, as well as in a control hub where you will provide advice over the phone.

All paramedics must be registered with the Health & Care Professions Council (HCPC).

Types of treatment given by paramedics

Paramedics use their skills to provide immediate care, sometimes in life-threatening situations. In these cases, they may carry out a range of emergency interventions, such as:

resuscitating and stabilising patients
establishing and maintaining an airway in a stepwise approach
stopping severe haemorrhage
using high-tech equipment, such as a defibrillator, pulse oximeters and end-tidal oxygen
applying spinal and traction splints
administering intravenous drips, drugs and oxygen.

In some settings, you may conduct advanced clinical assessments, with responsibility for the ongoing care provided, as well as referral and discharge.

Responsibilities

Your work will vary depending on the patient and their condition, but in general you'll need to:

listen to the patient and gain their consent (if possible) before undertaking any assessments and treatment
provide medical assessments and any immediate course of treatment prior to transporting them to a designated hospital
use technical equipment, including ventilators to assist breathing and defibrillators to treat heart failure, in order to resuscitate and stabilise
carry out certain surgical procedures when necessary, such as cannulation to insert a cannula into a large vein and endotracheal intubation (insertion of a breathing tube into the trachea)
monitor the patient's condition on an ongoing basis
decide if admission to hospital is necessary and assess how to move the patient safely
liaise with members of other emergency services, such as the police, fire brigade, coast guard and RNLI, and other ambulance services to ensure the appropriate level of response is provided
work closely with doctors, midwives and nurses in hospital emergency departments, briefing them as their patient arrives at hospital
liaise with allied health professionals such as radiographers, physiotherapists, occupational therapists and podiatrists to ensure a team approach to a patient's care journey
support family members, friends and members of the public at the scene
clean, decontaminate and check vehicles and equipment to maintain a state of operational readiness
assist other healthcare professionals with patient care in hospitals or healthcare centres
provide clinical advice to patients and other colleagues over the telephone from a control room
produce thorough case notes and report details about the patient's history, condition and treatment to relevant hospital staff
maintain patient confidentiality and act in a professional manner at all times
support and supervise student paramedics and new staff.

Salary

Salaries are covered by the Agenda for Change pay scales. Paramedic salaries start at Band 5, which ranges from £28,407 to £34,581. You'll usually move up to Band 6 (£35,392 to £42,618) after two years following a newly qualified paramedic pathway.
For team leaders or senior paramedics who have undertaken extended skills training in critical care or trauma, salaries are at Band 6/7 and fall between £35,392 and £50,056. Paramedics working in primary care or in a GP practice should expect to gain band 7 after a year.
If you continue to work up to the level of consultant paramedic, you could achieve a Band 8c salary of £70,417 to £81,138.

Employee benefits may include an NHS pension scheme, study leave for sponsored courses, relocation packages and access to counselling services and physiotherapy treatment.

Salaries outside the NHS may vary, depending on the sector and type of organisation.

Figures are intended as a guide only.

Working hours

The emergency ambulance service operates 24 hours a day, so you'll need to work shifts to cover this. You'll typically do 37.5 hours per week, which can be made up of evenings and nights, weekends and public holidays.

You may be required for additional stand-by and on-call duties, especially in remote areas.

Flexible working opportunities such as part-time work or job sharing may be available.

What to expect

You'll often be based at a local ambulance station and will have to respond to calls at any time of the day or night in all types of weather. You might also work in a hospital emergency department, GP surgery or minor injuries unit, or police custody suite.
Jobs are available in all NHS trust regions throughout the UK.
Uniforms are worn and protective clothing, such as a high-visibility jacket and boots, may be necessary.
The work is physically demanding and can be psychologically and emotionally challenging, particularly as ambulance crews are, at times, exposed to verbal and physical abuse. You will, however, receive conflict management training, which needs to be recertified every three years. Debriefing and counselling systems are also in place, and stress management courses are available. It can also be an extremely rewarding profession, as you are able to save lives.
Travel within the working day is a regular feature of the role. Occasionally, you may travel to a partner trust, but this is rare unless a major incident is called or if a patient transfer takes outside the trust area. Overseas work or travel is highly unlikely.

Qualifications

You must be registered with the Health & Care Professions Council (HCPC) to work as a paramedic. To become eligible to register, you'll need to successfully complete an HCPC-approved paramedic education programme.

There are several routes of learning. The most common route currently is to complete an HCPC-approved BSc Hons degree in paramedic science/paramedic practice. Degree courses are full time and last three or four years, combining theory and practical work placements.

To get a place on a course, you'll typically need two or three A-levels, including a science, as well as five GCSEs, including English language, science and maths at Grade 4 (C) or above. For some courses, you'll need a full UK manual driving licence with C1 (or provisional C1) status.

Another option, if you're based in England, is to apply for a position within an ambulance service trust as a student paramedic or to apply for a junior role and work your way up to the position of paramedic by doing a paramedic degree apprenticeship. Degree apprenticeships combine paid work with part-time study for a degree, allowing you to train on the job.

There is also a small number of MSc pre-registration courses (level 7) available to gain registration as a paramedic. These courses last two years full time. You will typically need an undergraduate degree in a human science or a healthcare related subject such as human science, nursing, midwifery or an allied health profession. You will also need relevant experience in a health environment. You may be considered if you have an non-relevant degree if you have considerable experience in a healthcare setting. Contact course providers for exact entry requirements.

Full details of all HCPC-approved paramedic science qualifications are available on the HCPC register of approved education and training programmes. A number of HCPC-approved programmes are also endorsed by the College of Paramedics. For details, see Endorsed Courses.

You'll need to undertake a criminal records check to train as a paramedic. Other common requirements are a fitness assessment and an occupational health assessment.

All eligible pre-registration undergraduate and postgraduate paramedic students studying at a university in England can receive funding support of at least £5,000 per year through the NHS Learning Support Fund. You don't have to pay it back and are still able to access funding for tuition and maintenance loans from the Student Loans Company. For more information, see Health Careers.

For details of financial support available elsewhere in the UK, see:

For more information on a career as a paramedic, see the College of Paramedics - Become a Paramedic.

Skills

You'll need to have:

excellent interpersonal skills for dealing with patients, their friends and family, and members of the public
strong teamwork skills to work alongside other crew, emergency services and hospital staff
the ability to work autonomously and to use your judgment to assess risks and make quick but considered decisions
oral, written and listening communication skills for reporting conditions
skills in problem solving and critical thinking
the ability to remain calm and focused under pressure
initiative and decision making skills
a calm and reassuring approach
resilience in the face of strong emotions
persistence and confidence to deal with challenging situations
integrity, honesty and self-awareness
a responsible and highly motivated approach to the work
general IT skills
good general fitness to cope with lifting patients and equipment
an understanding of the challenges facing health and social care
excellent driving skills - most NHS ambulance trusts will require you to be able to drive an ambulance under emergency conditions.

Work experience

You'll usually be expected to have some relevant health or social care experience to get a place on a course. This may include:

voluntary experience in organisations such as St John Ambulance, St Andrew's First Aid and British Red Cross
experience in life-saving techniques, which you can gain by volunteering as a community first responder in association with local ambulance services
experience as an emergency care assistant (supporting paramedics)
office-based work in an ambulance service.

If possible, see if you can spend time with an ambulance service and work shadow a paramedic to show course providers that you understand the role of a paramedic.

A current first aid certificate is also useful as it will show your interest in the work. Other experiences of working with sick, disabled and/or elderly people can also be useful.

It's useful to become a student member of the College of Paramedics. This will show your interest in, and commitment to, the profession and provide access to useful resources and support.

Find out more about the different kinds of work experience and internships that are available.

Employers

Most paramedics work for the NHS and are recruited and employed in individual NHS trust ambulance services covering specific geographical areas. These include:

ten individual NHS Ambulance Trusts in England (some of which have become Foundation Trusts)
Welsh Ambulance Services University NHS Trust
Scottish Ambulance Service
Northern Ireland Ambulance Service Health and Social Care Trust.

Job opportunities are therefore generally good, but the number of vacancies varies between regions across the UK.

There is a growing number of private companies providing ambulance services. They provide a range of services that can include:

specialist patient transfer
non-emergency patient journeys
cover at sporting fixtures, major events or on film and TV sets
support for NHS trust ambulance services when there is heavy demand.

Other opportunities exist with:

air ambulance services
the armed forces
GP surgeries
minor injuries units
higher education institutions
HM Prison Service
offshore oil and gas exploration companies
overseas health departments
telephone triage systems (e.g. NHS 111).

Look for job vacancies at:

Health Jobs UK
Jobs.hscni.net - health and social care jobs in Northern Ireland
NHS Jobs
NHSScotland Jobs

Private ambulance agencies covering specialist events can be found using internet search engines. Specialist recruitment agencies also advertise vacancies.

Professional development

When you join an ambulance service, you'll receive an induction to familiarise you with that particular service and you should be assigned a preceptor who is a more experienced paramedic.

You should have a period of preceptorship to help you in the transition from learner to independent paramedic.

After one year of post-registration experience, it's common to be developed as a practice placement educator so that you can also support other students who will work alongside you.

In order to remain registered with the HCPC, you must carry out continuing professional development (CPD). This includes doing a range of activities such as:

formal education
professional activity
self-directed learning
work-based learning.

Activities might include:

attending conferences
reading professional publications
joining a professional specialist interest group
work shadowing.

You can also take further qualifications at postgraduate level. This might be to progress to a role as a specialist paramedic in urgent and emergency care, for example, or to apply for an advanced paramedic position. Taking a management qualification, part time while working, may help you progress into a management position.

The College of Paramedics provides a post-registration career framework, CPD events and an annual conference. Membership provides benefits including various levels of insurance cover, access to a regional network and different resources and products.

Career prospects

With experience and further training, there are opportunities to move into more senior paramedic roles either within or outside of ambulance services. Paramedics work in a variety of clinical roles across health and care systems as well as roles in education, research and leadership.

As a senior paramedic it's possible in:

community hospitals
GP surgeries
health centres
hospital accident and emergency departments
minor injuries units.

It's also possible, with further training in critical care and trauma, to move into the senior role of critical care paramedic. Opportunities exist in some locations for specialist work with motorcycle, rapid response car or air ambulance (helicopter) units.

There are opportunities with extensive experience and training to progress into management posts in ambulance services such as operational manager, assistant director of operations or a senior position in the control room.

You may choose to move to related occupations in healthcare, either in a clinical role, such as nursing, or into non-clinical careers, such as NHS trust management and administration, training and development, or health and safety. You'll usually need further training and qualifications.

Careers in other uniformed services, such as the armed forces, police or fire service, are also an option, as are academic posts in higher education institutions.

Paramedic