Abstract

With National Health Service (NHS) providers facing the challenge of measurement through clinical outcomes, measures of effective service provision, this article explores the political influences; background and current approaches which have expanded paramedics’ scope of practice.As there are conflicting demands upon ambulance service NHS trusts provision of healthcare, these features are related to experiences within the London Ambulance Service, and where relevant to national experiences. The educational requirements, practitioner attributes, leadership development and service user perception are explored.In an environment where paramedics are expected to deliver innovative healthcare, partly driven by political influence it is important to understand how an extended scope of practice has involved and can be delivered while ensuring patient safety. In helping to shape the future delivery of out-of-hospital healthcare while integrating in the changing urgent and emergency provision, paramedics must remain aware of these multifaceted drivers upon their practice.

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