The guidelines were intended for use by clinicians, and commissioners of services intent on providing and planning care for those people who SH, while also emphasising the importance of the experience of care for service users and carers. This includes making sure there is provision for round-the-clock advice from mental health professionals, within the clinical support infrastructure in each 999 ambulance control room. Nice (2004 p.48) also forwards key priorities for implementation, which are provided on more detail in Appendix B, and include the need for respect, understanding and choice, staff training, effective triage, and an assessment of risk. The concept of paramedics has been around since the early days of Roman conquest, in which the older and less physically capable warriors were used intermittently to remove wounded soldiers. Before considering paramedics’ perceptions of caring for people who SH, it is important to recognise the context for the care that is provided by paramedics. 9th Dec 2019 Quinlivan et al (2014) found that a wide range of invalidated tools were in use among ED’s and mental health services, which, they suggested demonstrates little consensus over the best instruments for risk assessment, and reflects the style of service provision in that setting and a ‘high risk’ approach to management. The aim of the Concordat was for collaboration and improved care in a crisis for people with mental health problems, however the concordat resulted in joint statements, written and agreed by signatories, describing what people experiencing a mental health crisis should be able to expect of the public services that respond to their needs. idiosyncrasies of the paramedic role, potentially leaving students confused and defensive (Lane, 2014). This increased demand has created conditions of increasing and unremitting pressure in ED, with ambulance services suffering greater and greater delays at turnaround (the time from arrival at ED to becoming available for another call) (Robertson-Steel 2004). They are also based in specialist mobile units (e.g. The role of a paramedic varies widely across the world, as EMS providers operate with many different models of care. The purpose of this paper is to explore the differing staff perceptions in emergency ambulance services in the UK. However, a reduction have been seen in the baseline rate of 9.2 deaths per 100,000 population, in 1997, to 7.3 deaths per 100,000 population in 2011 (ONS 2014 b.). This short essay supports the growing role of paramedics in the clinical and academic workforce. Figure 2: Age-standardised suicide rates by sex, deaths registered between 1981 and 2015 (ONS 2015). They recognise that ambulance staff are increasingly better trained in providing care and treatment at the scene and during transportation to hospital for patients with diverse medical conditions, and are in a privileged position to give early treatment and psychological support for patients following SH. and wider issues which influence SH, are also important considerations to improving how paramedics respond to people who SH. The Mental Health Crisis Care Concordat (2014) provides specific guidance for ambulance services. It set out organisational goals and milestones, for the care of AMI, and many ambulance Trusts responded with strategies which included further development of their extended training into paramedic schemes. This recent qualitative study of student paramedics’ perception of the PEd role highlighted a lack of congruence between the current PEd model of mentorship and the mentoring requirements of student paramedics. The IHCD Paramedic programme had a major focus on the management of trauma, resuscitation and life threatening emergencies, with limited provision for psychosocial, mental health or behavioural presentations (IHCD 2003). There have long been concerns about the way in which health services, social care services and police forces work together in response to mental health crises.” (p.6). Our learning and development programme is one of the best in the UK. The UK has traditionally followed the Anglo-American model, relying on non-physicians such as Emergency Medical Technicians and Paramedics to staff ambulances. They added that if the incident was more critical, and there was insufficient time, crews should act more formally, and in the patients best interest as they currently act rather intuitively, using documentation to assess whether they perceive the patient to be at risk of suicide. The Mental Health Code of Practice (2015) calls for ambulance services to ensure they have in place a clear joint policy for the safe and appropriate admission of people in their local area, agreed at board or board-equivalent level by each party, and that each party should appoint a named senior lead. This included the Ministry of Health Committee (1966a; 1966b) report on the equipment and training of staff in the UK NHS ambulance service, which recommended a basic training programme lasting eight weeks for all emergency ambulance staff. The Concordat also provides examples of good practice such as the section 136 working group for Lincolnshire. The NSF (1999) identified care for those who SH as a key area to meeting a 20% reduction in suicides by 2010, and the National Service Framework on Mental Health (NSF MH 1999) was published to help meet these targets. The clinical scope of the paramedic role has broadened, and the opening of new patient pathways has enabled a broader range of treatment and referral options for attending ambulance crews. The NHS is an expanding organization, and since the year 2000 there has been a 17% increase in ambulance staff (NHS Confederation 2007b). Job opportunities are therefore generally good, but the number of vacancies varies between regions across the UK. Experienced paramedics have the option to progress quickly to dual roles, leadership and managerial roles, or upskill to become a Paramedic Practitioner, Consultant Paramedic or join our Hazardous Area Response Team. Officers may then use other powers under the MHA (1983). Thus in the modern role UK paramedics are ‘first responders’ who, in the absence of a doctor, make clinical decisions and autonomously administer clinical procedures. 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