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The Future Role and Education of Paramedic Ambulance Service Personnel (Emerging Concepts)
Publications > The future role... > Cost implications
8. Cost implications
8.1 For historical reasons,
the cost of training ambulance staff is currently excluded from the
Non-Medical Education Training (NMET) levy which covers the education of
nurses and most other non-medical professions in England. Their training
therefore falls outside the remit of Regional Education Strategy Groups.
Whilst in training ambulance staff are currently employed by their
respective Trust, with salary and raining costs borne directly by each
employer.
8.2 A cohort of ambulance
staff trained to higher levels than existing paramedics has cost
implications that require careful consideration. The extent will depend
mainly on the numbers required, their employment status whilst training,
pay differentials on completion, and the initial costs of developing
suitable academic courses. The costs will be offset in part by savings in
ambulance service training budgets, better utilisation of currently
unproductive time, and also from a range of wider potential benefits in
the wider health care system. These will include reduced attendance at
Accident Emergency Departments that will result from better working
flexibility and improved clinical judgement. Not all of any such savings
would accrue to ambulance services, but in the broader context would still
be seen as advantageous. The balance of this complex equation cannot yet
be calculated in detail, but some of the important principles can be
outlined.
8.3 With the introduction
of call prioritisation, the development of rapid response units and the
search for alternative ways of delivering emergency care it has been
estimated that approximately 20-30% of the current workforce (comprising
8000 practicing paramedics) could potentially be employed as PEC's in the
future. Local variation is to be expected depending on circumstances and
specific needs. Currently about 500 new paramedics are trained annually,
but new national performance standards are likely to lead to increased
recruitment. Thus, the actual number of PEC's required can be truly
established only by considering manpower plans on a service by service
basis and in the context of their local healthcare systems.
8.4 The primary Degree in
Emergency Care would not necessarily be the responsibility of Ambulance
Trusts or indeed the Health Service, but the supplementary training to
full operational capability would be. It will be additional to and not
replacing some current commitments. Conversion courses for existing
paramedics would be a further cost.
8.5 Using nurse training as
a model, student PEC's would not become employees until qualification.
Tuition costs could amount to £5,000 per student per annum, with an
additional sum of £5500 to cover the cost of a bursary. The three year
total of £31500 should be considered against the current estimated cost
of training from recruitment to paramedic qualification of £18500 which
includes salary whilst on training courses together with other expenses.
8.6 We can reasonably
assume that the additional staff required for rotation into Accident and
Emergency Departments would be covered by contractual arrangements with
Hospital Trusts which will benefit from services of personnel experienced
in both pre-hospital and in-hospital emergency care.
8.7 The cost of developing
the proposed academic course is expected to be modest as much of the
content is already used in other areas. There will be some additional
costs associated with practical/supervised training in the fourth year and
the additional costs of offering conversion courses to existing paramedics
may need to be considered. Some additional pay costs must also be
anticipated and it would seem opportune to factor a higher qualified grade
of emergency care provider into the wider national examination of pay
structures which is currently the subject of discussion and consultation.
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