Consensus towards understanding and sustaining professionalism in paramedic practice

Start date

17 June 2014

End date

13 January 2015


Paramedic practice is complex, pressured and involves decision making in unscheduled and emergency situations. Paramedics work with people who are vulnerable and a high level of professionalism is required to respond appropriately.

The patients and families paramedics encounter will often be distressed, anxious and sometimes aggressive. Little is known about professionalism in relation to UK paramedic practice. The aim of this project was to develop an in-depth understanding of professionalism in relation to UK paramedic practice.

Aims and objectives

This was a four phase study:

  1. A literature review
  2. A Delphi process enabling consensus to be reached by an expert panel on key questions relating to paramedic professionalism
  3. Qualitative interviews with clinical managers, specialist paramedics and student paramedics
  4. The development of related educational materials.


The project team would like to thank members of the expert Delphi panel and interview participants, who gave so generously of their time and ideas.

We are very grateful to the South East Coast Ambulance Service NHS Foundation Trust (SECAmb) for funding this project and to their research and development sub-group who reviewed the project.



Project team

Andy Collen

South East Coast Ambulance Service NHS Foundation Trust

Stuart Rutland

South East Coast Ambulance Service NHS Foundation Trust

Claire Horsfield

University of Surrey

Joan Juniper

University of Surrey

Emma Relf

University of Surrey

Verity Snook

University of Surrey

Kit Tapson

University of Surrey



Findings suggest that the meaning of paramedic professionalism has four key components:

  1. The conduct and character of paramedics
  2. The role of regulation
  3. Professional education
  4. The values that paramedics profess.

Project data support the view that professionalism enablers and inhibitors in relation to paramedic practice are at three levels:

  1. Micro-level – Paramedics’ behaviour, values, attitudes and educational preparation
  2. Meso-level – Organisational culture and issues such as support for staff in terms of education, debriefing provision and valuing human over other resources
  3. Macro-level – On-going education and research to build the evidence base and develop ethics education programme.


Four areas of recommendation were outlined as follows:


Paramedic leaders to identify interventions that promote the well-being of paramedics. Organisational attention to the role modelling and enactment of ethical leadership. Consideration of the benefits and risks of: shift patterns; length of service: workload: and means to promote regular meal breaks and rest periods for paramedics.


Provide opportunities for graduates to access degree programmes with a view to promoting professionalism. Universities and ambulance Trusts to collaborate on initiatives to sustain professionalism learning points. Develop practice based accessible educational materials.


Commission research on the relationship between the moral climate of ambulance Trusts and paramedic well-being and moral distress. Research the impact of workload balance and individual capacity. Conduct qualitative research regarding patient and family/friends perspective of paramedic professionalism


The CUSPPP project team to collaborate with the College of Paramedics to develop guidance on paramedic professionalism and to disseminate educational materials produced from the project.


The professionalism enablers identified by this project revealed a good deal of consensus regarding participants’ view of broader factors that impact on professionalism. These are the role of regulation, of regulators’ codes and standards, professional education and the responses of the general public. There were suggestions also that other professions, such as GP’s, do not always give paramedics the respect they deserve.

The data highlights the view that responsibility for paramedic professionalism goes beyond individuals with organisations having a key role in providing support. Considering and valuing paramedics as persons rather than focusing on vehicles as the most important resource is important. The role of ambulance trusts in promoting and enacting professional values was also highlighted as an important professionalism enabler.

Research groups and centres

Our research is supported by research groups and centres.

The International Care Ethics (ICE) Observatory  understanding people's relationships with social and physical environments research theme

Research themes

Find out more about our research at Surrey: