The professional accountability of paramedics

Staff pic   para epaulettes

The guidelines focus on identifying when it is appropriate for a paramedic to either not travel (in the case of an RRV) or not be in the patient care compartment (such as driving).

The term professional accountability relies on you as an individual paramedic to:

  • practice within your scope of practice
  • use the Health and Care Professions Council (HCPC) standards relevant to your registration (particularly standards of proficiency for Paramedics – 1a and 1b, but the other areas also have relevance)
  • be aware that you may be asked to justify or account for your actions or decisions.
  • remain fit and current for practice
  • base decisions acting in best interest of service users
  • act in a non-discriminatory manner in thought and action
  • act within legal and regulatory frameworks
  • act within your own training and ability.
  • seek advice or refer where appropriate if you’re unsure of anything
  • delegate the care of the service user appropriately to their individual needs, considering scope of practice of the staff and their competency.

This is particularly relevant for us as paramedics in terms of transporting patients, i.e. when considering when to not travel (in the case of an RRV), or not be in the patient care compartment (such as driving). It is important for us to all recognise that each situation may appear different. However, there are common points to consider with regards to assessing our professional accountability.

We are familiar with the term dynamic risk assessment and this can be applied to these forms of decisions. We also consider the terms used to risk score of consequence (actual or potential effect) and likelihood (how often).

These provide us the following points to consider professional accountability:

Condition of the patient and whether they are likely to require any interventions or monitoring above the scope of the clinicians you are handing over to, i.e. ongoing pain relief?

Is there a realistic predictability that the patient is likely to deteriorate?

Is there a legal reason you should continue the care of the patient?

On any safety netting are you confident that the individuals are able to understand and deliver what may be required?

Is there a risk that I am aware of but have considered the consequences that you will either do no harm or do good for the service user?

Remember with registered professionals the expectation is that accountability rests with you.


Obviously, these principles can and should also be used by our EMTs and ECAs, both when working with a paramedic or another colleague. When working with a paramedic, communication is key. If you aren’t sure or the situation requires, it’s important to ask.

If you’re an EMT working with another EMT, or are a student paramedic/ECA crew, it is expected that your accountability will be in line with your job description, training and competency. In other words, the expectation is that you will always do the best you are able and are trained for. For ECAs, it’s important that you’re aware of the monitoring and needs of the patient, that you use the red flag approach, and aren’t afraid to ask for assistance when appropriate.

Everyone, regardless of job role, should raise concerns or discuss factors that could affect patient care.

Remember, if you need advice on scene you can contact the Trust’s Clinical Advice Line on 07753 950843. It’s staffed by senior clinicians and is available 24/7 to help you when you need it.

Published 28th January, 2016

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