# Job market in England



## Motojunkie (Sep 5, 2010)

English medics- How's the job market for paramedics in England right now? This down economy is obviously hurting the U.S. pretty bad so I was wondering how you guys are faring. I'm still a little unfamiliar with the English EMS system, so can you include whether it's public or private companies. TIA


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## Scott33 (Sep 6, 2010)

It is a public service in the UK (England plus those other 3 countries) so recruitment is ongoing throughout the year. All degree-based these days, and the number of applicants way outnumber the amount of places available in the various universities and trusts.


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## MrBrown (Sep 6, 2010)

Other 3 countries eh .... just not Wales right, which has been sawn off out of embarrasment? 

Paramedic (ALS) practitioners in the UK are University Degree educated these days ... the UK does not have a lesser level of clinical person as Technician is being removed from what I hear.


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## Scott33 (Sep 6, 2010)

They still have techs, but you are right about them being phased out, although ECAs are replacing them. A tech without the tech skills - basically a driver.

http://www.nhscareers.nhs.uk/details/Default.aspx?Id=2045


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## jjesusfreak01 (Sep 6, 2010)

Scott33 said:


> They still have techs, but you are right about them being phased out, although ECAs are replacing them. A tech without the tech skills - basically a driver.
> 
> http://www.nhscareers.nhs.uk/details/Default.aspx?Id=2045



Looking at that page, an ECA appears to be somewhere between an FR and an EMT. Is that a correct assessment, and are techs trained to a higher level than US EMTs?


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## Scott33 (Sep 7, 2010)

Yeah, pretty much spot on with the ECA.

Techs, though a dying breed, can insert LMAs, give IM narcan, IM epi, N20, ASA, GTN, hook up and transmit 12-leads etc as well as the other BLS stuff common with the basic EMT.

There is no medical control in the UK...at all...ever, so all decisions are at the discretion of the individual provider (in association with JRCALC guidelines). It is not uncommon to leave many patients at home or advise them to make their own way to hospital (I am sure we all know the type of calls I am talking about). At paramedic level and above, utilizing alternative clinical pathways are commonplace. ECPs can perform minor procedures in the home, such as wound irrigation and suturing, Foley changes, urinalysis and opthalmology - including writing their own prescriptions for ABx where applicable. They can also order diagnostic tests like x-rays etc, without the need for the patient to be seen by a doctor in the ED. Direct referrals to social services or psych facilities also skip the ED.

The system is not without its faults, but clinical autonomy, alternative care pathways, education, and scope of practice take on a whole new meaning when the idea is *not* to send as many people to the ED, as is humanly possible.


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## MrBrown (Sep 7, 2010)

Sounds smashing, but I vowed never to return to England coz it rained a lot and I couldn't find decent fish and chips.

I am dissapointed at the removal of the Ambulance Technician and replacement of them with ECAs ... a Paramedic needs another Paramedic or a good Ambulance Officer/Ambulance Technician to work with.


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## Scott33 (Sep 7, 2010)

MrBrown said:


> Sounds smashing, but I vowed never to return to England coz it rained a lot and I couldn't find decent fish and chips



God, it's all I used to eat when I lived in the UK. Well, that and deep fried pizza. I reckon the north atlantic Salmon could put your Mangonui Fish shop to shame. 



> I am dissapointed at the removal of the Ambulance Technician and replacement of them with ECAs ... a Paramedic needs another Paramedic or a good Ambulance Officer/Ambulance Technician to work with.



I did say the system was less than perfect, and the ECA in favor of the Tech is a good example of this. There have been many instances, due to shortage of coverage, that double ECA crews have been left to handle calls. It doesn't help when the underclass component of the demographic, think nothing of trying to use ambulance service as a free taxi, at weekends and around the holiday season...

One 999 call every 7 seconds


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## InsidiousStealth (Sep 19, 2010)

What's an ECA?


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## MrBrown (Sep 19, 2010)

Emergency Care Assistant - make no mistake, they are solely there to assist the State Registered Paramedic (as the registered healthcare provider) and do not a lot more than drive.


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## InsidiousStealth (Sep 19, 2010)

that kinda sucks, I always thought it best to have EMT's work with paramedics and both assist in treatment equally. It adds more of the "teamwork" thing to it

Although there are occasions where one will do more work then the other but im sure you know what i mean


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