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A review of key national reports to describe the development of paramedic education in England (1966–2014)
  1. Ingrid Ann Brooks1,
  2. Matthew Cooke2,
  3. Caroline Spencer3,
  4. Frank Archer3
  1. 1Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
  2. 2Warwick Medical School and Heart of England NHS Foundation Trust, Birmingham, West Midlands, UK
  3. 3Disaster Resilience Initiative, Monash Injury Research Institute, Monash University, Clayton, Victoria, Australia
  1. Correspondence to Ingrid Ann Brooks, Faculty of Medicine, Nursing and Health Sciences, School of Nursing and Midwifery, Monash University, Clayton Campus, Wellington Road, Clayton, VIC 3800, Australia; ingrid.brooks{at}


Introduction In the year 1966, important advances in mobile coronary care and trauma care in the UK and USA influenced globally the development of modern prehospital emergency services and paramedic education. In that year, to meet the evolving role of prehospital care in the UK, the ‘Millar Report’ specified a new syllabus for ambulance personnel in England. As the 50th anniversary of this report approaches, this paper reviews key national UK reports to describe the development of paramedic education in England over this period.

Methods A hand search of documents available and a Google search identified documents in the public domain. MEDLINE and CINAHL Plus were searched for peer-reviewed publications. Thematic analysis was used to identify descriptive themes.

Results Of the 83 reports and 431 articles screened, 33 documents met our inclusion criteria. We identified four historical periods in English paramedic education: development of paramedic education (1966–1996); paramedic role changes influencing education (1997–2004); paramedic education level changes and the emergency care practitioner (2005–2008); and paramedic education for the future (2010–2014). Our discussion of four descriptive themes: government authority and policy, influence of health professions, quality assurance and development of the paramedic profession includes comparisons with paramedic education in the USA and Australia.

Conclusions Political reform agendas and initiatives and advances in clinical medicine largely shaped paramedic roles and education in England. The degree to which the paramedic profession initiated education development is difficult to determine from the literature. Overall, a nationally coherent standard for paramedic education in England needed five decades to develop and mature.

  • emergency ambulance systems
  • education

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  • Contributors IAB, FA and CS developed the concept and design of the review; IAB and FA performed the hand searches; IAB conducted the literature search; IAB, FA and MC reviewed the literature; IAB wrote the manuscript; MC reviewed the paper for completeness and accuracy; all authors contributed to the interpretation of the data and undertook a critical review and editing of the article prior to submission.

  • Competing interests MC was the National Clinical Director for Emergency Care in England during some of this period, and therefore, was involved in some of the policy development described.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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