Developing leadership in the UK’s ambulance service: a review of the consultant paramedic role

Abstract published with permission. Background: This study seeks to understand part of the emerging clinical leadership framework implemented in the UK’s NHS ambulance services in recent years. The aim is to explore the relatively new role of consultant paramedics and understand their leadership activities in relationship to nationally determined requirements, and the challenges they face performing this crucial leadership role. Methods: Semi-structured interviews were conducted with all consultant paramedics in the UK in 2013. Thematic analysis and coding were used to analyse the data and identify emergent themes. Additionally, basic demographic data was collected for comparison against national requirements. Findings: The findings illustrated three key themes: credible clinical leadership, an emerging empowered profession, and role expectations. There is a clear indication that consultant paramedics are a key part of clinical leadership for the paramedic profession. However, they are challenged to remain clinically competent by undertaking regular clinical practice and providing visible leadership on the ground, while strategically taking the profession forward. Operational resistance and power issues were highlighted as some of the problems faced by these clinical leaders. Implications: The findings may prove useful for employers in reviewing their clinical leadership structures, and in workforce planning for future consultant paramedics. The paramedic profession and its professional body may equally find this study useful for informing future strategic planning