Table 1

Skill level competencies of ambulance clinicians in London

Skill level	Role and responsibilities
Emergency medical technician 2	Supervised patient assessment, administration of selected prescription medications, provision of ambulance aid, blue light driving.
Emergency medical technician 3	Unsupervised patient assessment, administration of selected prescription medications, provision of ambulance aid, blue light driving.
Paramedic	Unsupervised patient assessment, provision of ambulance aid, blue light driving.
	Extra skills: cannulation, advanced airway management, administration of extended prescription medications.
	Lead clinician on scene responsible for care of the patient and scene management.
	Registered under the health professions council.
Paramedic team leader	Unsupervised patient assessment, provision of ambulance aid, blue light driving.
	Extra skills: cannulation, advanced airway management, administration of extended prescription medications.
	Lead clinician on scene responsible for care of the patient and scene management.
	Clinical lead/role model for practice.
	Registered under the health professions council.
Emergency care practitioner	Autonomous advanced patient assessment, provision of ambulance aid, blue light driving.
	Extra skills: cannulation, advanced airway management, administration of further extended prescription medications, minor injury treatment, community referrals.
	Lead clinician on scene responsible for care of the patient and scene management.
	Registered under the health professions council.