Emergency care assistant

An Emergency Care Assistant (ECA) is a type of NHS ambulance service worker in the United Kingdom, often used to support paramedics in responding to emergency calls. This frontline staff role was introduced in 2006 as part of the modernisation of NHS emergency ambulances and also to lower costs. By 2011 there were 2000 people working as ECAs in the United Kingdom.

The role is evolving rapidly, and there is variation across the country, although usually the role involves assisting paramedics. ECAs commonly help to transfer patients and may use advanced driving skills. They may carry out basic diagnostic procedures under the direct supervision of a paramedic. The College of Paramedics has said that it expects that ECAs will not be called upon to make complex clinical decisions.

Problems with implementation

By 2007 there were a range of healthcare professionals who had expressed reservations about the plans to introduce large numbers of ECAs. Unions representing ambulance workers had fears that the workforce changes could lead to an increase in the risk to patients as well as adding to the workload of paramedics.

Each regional ambulance service currently determine its own criteria around what is needed to become an ECA. They are amongst the lowest paid front line staff in the NHS, being paid at an AfC band 3.

Many ambulance services across the United Kingdom have now ceased to recruit further ECAs, and are now focusing on the reemerging role of the Ambulance Technician. Many NHS ambulance services are now offering the opportunity for Technicians to progress onto a Paramedic Science DipHE/FdSc programme.

The death of the ambulance technician?

In 2013 unions had expressed concern about the widespread removal of technician posts in Yorkshire and had written to East Midlands Ambulance Service to ask for the reintroduction of the technician role. In December 2014, after a steep rise in the number of paramedics on long term sick leave suffering stress, Yorkshire said they would be bringing back the technician role, recognising their value in emergency situations.

The role of ambulance technician was being phased out of most UK NHS Ambulance trusts, with those employed within this role being encouraged to commit to the paramedic science degree to qualify them as paramedics, or accept a role as an emergency care assistant. Technicians who opt to apply for the degree will be given the opportunity providing they agree to partake in an access course, though it is not realistic to assume that all technicians will be successful or indeed capable of completing the course due to negative attitude and those who are likely to retire where advanced training will be of no interest.

Concern was also raised about the amount of driving an ECA has to do during a 12-hour shift as driving time regulations do not apply to emergency services. Whilst any member of staff may drive when responding to an emergency case, only the unqualified ECA was able to drive when a patient is on board and been transferred to the emergency department at the senior clinicians discretion. As of 2015, due to the current state of the front line of the NHS, the majority of ambulance calls are non-emergency related can be dealt with ECA personnel or through self management.

Career development

There is a route for some ECAs to progress to Technician level. A training programme is run by the East of England Ambulance Service NHS Trust (EEAST) which aims to help ECAs progress to technician within 1 year of their basic training; by November 2015, most ECAs working for the East of England Ambulance Service NHS Trust (EEAST) have made the transition from ECA to Technician on this programme.

ECAs who wish to progress to become a paramedic will need to complete a University degree, Some employers do provide structured training to support this, with an expectation that it would take at least two and a half years for an ECA to complete this on a part-time basis.

External links

• www.emergencycareassistant.co.uk