Inadequate paramedic training for safe emergency assessment and treatment
First to latest report 9 Apr 2014 — 16 Sep 2025
Reports that mention this concern
9
Times this concern has been raised
9
Stated actions linked to this concern
21
What this concern includes
Includes failures of paramedic foundation training, initial training, refresher training, continuing professional development, clinical-skills education or competence preparation where they impair safe emergency assessment, recognition, decision-making or treatment by paramedics, including the anchor's failure to cover atypical myocardial infarction signs and distinct gaps concerning other emergency presentations.
What is not included
Excludes training deficiencies concerning non-paramedic workforces unless the report explicitly identifies paramedic training as the deficient system.
Excludes generic ambulance staffing, equipment, governance or communication failures that are not directly part of paramedic training or competence preparation.
Excludes deficiencies confined to one clinical condition's pathway where paramedic training is not the shared unsafe condition.
Excludes failures by paramedics to apply adequate training in practice when the training system itself is not deficient.
Excludes specialist clinical treatment or referral failures occurring after paramedics have received and can apply the relevant training.
Trends
Reports over time
Reports mentioning this concern, over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Association of Ambulance Chief Executives4
East Midlands Ambulance Service NHS Trust3
Department of Health and Social Care2
Health and Care Professions Council2
East of England Ambulance Service NHS Trust1
Epsom Hospital1
Essex Partnership University NHS Foundation Trust1
General Chiropractic Council1
Health Services Safety Investigations Body1
Kettering General Hospital1
Mid and South Essex NHS Foundation Trust1
NHS Birmingham and Solihull Integrated Care Board1
NHS Black Country Integrated Care Board1
NHS Coventry and Warwickshire Integrated Care Board1
NHS Derby and Derbyshire Integrated Care Board1
NHS trust8
Health-sector membership body4
Health and care professional regulator3
Integrated care board3
Executive non-departmental public body2
Healthcare site2
Ministerial department2
Coronial office1
Type not available1
Reports and published responses 9 reports
See individual reports that have raised this concern, and the actions taken in response
Birmingham and Solihull
Concerns raised1
Lack of mandatory and comprehensive paramedic training in obstetric emergencies
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Linked responses
Association of Ambulance Chief Executives
West Midlands Ambulance Service University NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.6
West Midlands Ambulance Service University NHS Foundation Trust
Provide regulated obstetric-emergency and breech-birth training through the AAP and Graduate Paramedic Induction programmes.
West Midlands Ambulance Service University NHS Foundation Trust
Deliver practical breech-birth simulation sessions using Victoria mannequins and other maternity training equipment, updated following the new guidance.
West Midlands Ambulance Service University NHS Foundation Trust
Purchase and deploy five Victoria birthing mannequins for realistic obstetric-emergency simulation training.
West Midlands Ambulance Service University NHS Foundation Trust
Include obstetric emergencies, including breech birth, in mandatory face-to-face refresher training for all ambulance clinicians during 2026–2027.
West Midlands Ambulance Service University NHS Foundation Trust
Provide continuing professional development through maternity roadshows, themed maternity learning and expert-led obstetric-emergency simulation.
West Midlands Ambulance Service University NHS Foundation Trust
Relaunch the e-PROMPT obstetric-emergency course and make it available for clinicians to complete.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.6
West Midlands Ambulance Service University NHS Foundation Trust
The e-PROMPT course was unavailable because guidance updates paused it, not because resourcing prevented clinicians from completing it.
Disputes the concernThe respondent disagreed with part of the concern or the basis for it.
West Midlands Ambulance Service University NHS Foundation Trust
Relevant obstetric content in broader refresher training and CPD, alongside accessible JRCALC guidance, is considered sufficient without a standalone mandatory module.
Existing arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Association of Ambulance Chief Executives
Responsibility for paramedic training and education falls outside AACE’s remit.
Outside remitThe respondent said that this matter was outside its role or authority.
Association of Ambulance Chief Executives
Training concerns were shared with ambulance education and clinical networks for consideration by their organisations.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Association of Ambulance Chief Executives
Qualified paramedic maternity training is the responsibility of individual ambulance trusts.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Association of Ambulance Chief Executives
AACE has no control over allocating specific funding for maternity training.
Unable to actThe respondent said that a constraint prevented them from taking the relevant action.
Surrey
Concerns raised1
Inadequate paramedic training for mental capacity assessments
This report raised 12 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked responses
Health and Care Professions Council
Health Services Safety Investigations Body
NHS Southwest London Integrated Care Board
South East Coast Ambulance Service NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.6
Health and Care Professions Council
Consider changes to the paramedic Standards of Proficiency during the next scheduled review in 2027–2028.
Health and Care Professions Council
Review the Standards of Education and Training governing preparation of learners for professional practice.
Health and Care Professions Council
Launch a public consultation on proposed changes to the Standards of Education and Training.
Health Services Safety Investigations Body
Launch an investigation into ambulance responses to mental health crisis calls via NHS 111 and 999, covering triage, training, capacity assessment, and conveyance decisions.
South East Coast Ambulance Service NHS Foundation Trust
Provide a half-day suicidality and mental health training session within the 2026/27 annual clinical update programme.
South East Coast Ambulance Service NHS Foundation Trust
Deliver revised scenario-based mental health learning for new operational staff and clinicians, covering pathways, collaboration, law, capacity and complex presentations.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.5
Health and Care Professions Council
Setting curricula and designing training courses are outside the respondent’s role.
Outside remitThe respondent said that this matter was outside its role or authority.
Health and Care Professions Council
Other bodies are responsible for setting paramedic curricula and designing training courses.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
NHS Southwest London Integrated Care Board
Clinical matters fall outside the commissioning organisation’s remit.
Outside remitThe respondent said that this matter was outside its role or authority.
NHS Southwest London Integrated Care Board
Clinical matters are the responsibility of the relevant Trusts.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
NHS Southwest London Integrated Care Board
The Surrey Safeguarding Board will lead the Safeguarding Adults Review, with the organisation participating.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Gateshead and South Tyneside
Concerns raised1
Lack of paramedic training on transient stroke symptoms
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
North East Ambulance Service NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
North East Ambulance Service NHS Foundation Trust
Feed back stroke-symptom learning to the attending paramedic.
North East Ambulance Service NHS Foundation Trust
Issue a wider update to paramedics reminding them that stroke symptoms may dissipate over time.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
North East Ambulance Service NHS Foundation Trust
Paramedics are trained to recognise stroke and TIA symptoms, including symptoms that have resolved before assessment.
Disputes the concernThe respondent disagreed with part of the concern or the basis for it.
West Yorkshire (Western)
Concerns raised1
Lack of paramedic training in identifying herald bleeds
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Linked response
Association of Ambulance Chief Executives
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Association of Ambulance Chief Executives
Develop guidance on recognising infected surgical wounds near blood vessels and catastrophic bleeding, update the vascular emergencies guidance, and publish it through the clinical app.
Essex
Concerns raised1
Failure to incorporate investigation learning into training and alerts
This report raised 10 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
East of England Ambulance Service NHS Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
East of England Ambulance Service NHS Trust
Include a case study in the Safety Matters Newsletter covering adrenaline, paediatric airway management and handover communication during critical asthma incidents.
Northamptonshire
Concerns raised1
Lack of paramedic training in the use of buccal midazolam
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
East Midlands Ambulance Service NHS Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
East Midlands Ambulance Service NHS Trust
Develop an action plan covering training for staff who access or administer buccal midazolam, including patient-held medication.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
East Midlands Ambulance Service NHS Trust
No audit of buccal midazolam training was required because it was not in the medicines formulary at the time.
No action considered necessaryThe respondent said that no further action was needed.
Birmingham and Solihull
Concerns raised1
Failure of paramedic foundation training to cover arm pain as an atypical sign of myocardial infarction
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
Health and Care Professions Council
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Health and Care Professions Council
Review the paramedic standards of proficiency for possible amendments addressing the concerns raised.
Health and Care Professions Council
Liaise with the College of Paramedics about whether the paramedic standards of proficiency should be amended.
Nottinghamshire
Concerns raised1
Lack of training on placental abruption presentations and fetal risk despite reassuring maternal signs
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Nottinghamshire
Concerns raised1
Insufficient initial and refresher training for paramedic intubation
This report raised 5 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
Association of Ambulance Chief Executives
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Association of Ambulance Chief Executives
Develop a nationally recognised teaching standard for stepwise airway management, ventilation and paramedic intubation competency.
Association of Ambulance Chief Executives
Implement annual reassessment of advanced airway skills using individual airway logs, performance frequency and problems encountered, including authority to continue intubation.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Association of Ambulance Chief Executives
Each ambulance service will decide whether intubation remains a core skill or is restricted to specialised and advanced paramedics.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.