The standards of proficiency for paramedics
These standards set out safe and effective practice in the professions we regulate. They are the threshold standards we consider necessary to protect members of the public.
Professionals must meet all the standards of proficiency to register with us and meet the standards relevant to their scope of practice to stay registered with us.
A note about our expectations of you
You must meet all the standards of proficiency to register with us and meet the standards relevant to your scope of practice to stay registered with us.
If your practice is called into question, we will consider these standards (and the standards of conduct, performance and ethics) in deciding what action, if any, we need to take.
The standards of proficiency complement information and guidance issued by other organisations, such as your professional body or your employer. We recognise the valuable role played by professional bodies in providing guidance and advice about good practice which can help you to meet the standards in this document.
We also expect registrants to meet the HCPC standards of conduct, performance and ethics and standards for continuing professional development.
Your scope of practice
Your scope of practice is the area or areas of your profession in which you have the knowledge, skills and experience to practise lawfully, safely and effectively, in a way that meets the standards and does not pose any danger to the public or to yourself.
We recognise that a registrant’s scope of practice will change over time and that the practice of experienced registrants often becomes more focused and specialised than that of newly registered colleagues. This might be because of specialisation in a certain area or with a particular client group, or a movement into roles in management, education or research. Every time you renew your registration, you will be asked to sign a declaration that you continue to meet the standards of proficiency that apply to your scope of practice.
Your particular scope of practice may mean that you are unable to continue to demonstrate that you meet all of the standards that apply for the whole of your profession.
As long as you make sure that you are practising safely and effectively within your given scope of practice and do not practise in the areas where you are not proficient to do so, this will not be a problem. If you want to move outside of your scope of practice, you should be certain that you are capable of working lawfully, safely and effectively. This means that you need to exercise personal judgement by undertaking any necessary training or gaining experience, before moving into a new area of practice.
Meeting the standards
It is important that you meet these standards and are able to practise lawfully, safely and effectively. However, we do not dictate how you should meet the standards. There is normally more than one way in which each standard can be met and the way in which you meet the standards might change over time because of improvements in technology or changes in your practice.
We often receive questions from registrants who are concerned that something they have been asked to do, a policy, or the way in which they work might mean they cannot meet the standards. They are often worried that this might have an effect on their registration.
As an autonomous professional, you need to make informed, reasoned decisions about your practice to ensure that you meet the standards that apply to you. This includes seeking advice and support from education providers, employers, colleagues, professional bodies, unions and others to ensure that the wellbeing of service users is safeguarded at all times. So long as you do this and can justify your decisions if asked to, it is very unlikely that you will not meet the standards.
We recognise that our registrants work in a range of different settings, which include direct practice, management, education, research and roles in industry. We also recognise that the use of terminology can be an emotive issue.
Our registrants work with very different people and use different terms to describe the groups that use, or are affected by, their services. Some of our registrants work with patients, others with clients and others with service users. The terms that you use will depend on how and where you work. We have used terms in these standards which we believe best reflect the groups that you work with.
In the standards of proficiency, we use phrases such as ‘understand’ and ‘know’. This is so the standards remain applicable to current registrants in maintaining their fitness to practise, as well as prospective registrants who have not yet started practising and are applying for registration for the first time.
Standards of proficiency
These standards are effective from 1 September 2023.
The standards include generic elements, which apply to all our registrants, and profession-specific elements, which are relevant to registrants belonging to one of the professions we regulate.
The standards are not hierarchical and are all equally important for practice.
- The generic standards, which apply to all professions, are written in bold text.
- The profession-specific standards are written in plain text.
At the point of registration, paramedics must be able to:
1.1 identify the limits of their practice and when to seek advice or refer to another professional or service
1.2 recognise the need to manage their own workload and resources safely and effectively, including managing the emotional burden that comes with working in a pressured environment
1.3 keep their skills and knowledge up to date and understand the importance of continuing professional development throughout their career
1.4 use a range of integrated skills and self-awareness to manage clinical challenges independently and effectively in unfamiliar and unpredictable circumstances or situations
1.5 work safely in challenging and unpredictable environments, including taking appropriate action to assess and manage risks to themselves and service users and carers
2.1 maintain high standards of personal and professional conduct
2.2 promote and protect the service user’s interests at all times
2.3 understand the importance of safeguarding by actively looking for signs of abuse, demonstrating understanding of relevant safeguarding processes and engaging in these processes where necessary
2.4 understand what is required of them by the Health and Care Professions Council, including, but not limited to, the standards of conduct, performance and ethics
2.5 respect and uphold the rights, dignity, values and autonomy of service users, including their role in the assessment, diagnostic, treatment and/or therapeutic process
2.6 recognise that relationships with service users, carers and others should be based on mutual respect and trust, maintaining high standards of care in all circumstances
2.7 understand the importance of and be able to obtain valid consent, which is voluntary and informed, has due regard to capacity, is proportionate to the circumstances and is appropriately documented
2.8 understand the importance of capacity in the context of delivering care and treatment
2.9 understand the scope of a professional duty of care, and exercise that duty
2.10 understand and apply legislation, policies and guidance relevant to their profession and scope of practice
2.11 recognise the power imbalance that comes with being a healthcare professional, and ensure they do not abuse this for personal gain
2.12 practise in accordance with current legislation governing the use of medicines by paramedics
2.13 understand the criteria required for making a self-referral and when to proceed
3.1 identify anxiety and stress in themselves and recognise the potential impact on their practice
3.2 understand the importance of their own mental and physical health and wellbeing strategies in maintaining fitness to practise
3.3 understand how to take appropriate action if their health may affect their ability to practise safely and effectively, including seeking help and support when necessary
3.4 develop and adopt clear strategies for physical and mental self-care and self-awareness, to maintain a high standard of professional effectiveness and a safe working environment
4.1 recognise that they are personally responsible for, and must be able to justify, their decisions and actions
4.2 use their skills, knowledge and experience, and the information available to them, to make informed decisions and/or take action where necessary
4.3 make reasoned decisions to initiate, continue, modify or cease treatment, or the use of techniques or procedures, and record the decisions and reasoning appropriately
4.4 make and receive appropriate referrals, where necessary
4.5 exercise personal initiative
4.6 demonstrate a logical and systematic approach to problem-solving
4.7 use research, reasoning and problem-solving skills when determining appropriate actions
4.8 understand the need for active participation in training, supervision and mentoring in supporting high standards of practice, and personal and professional conduct, and the importance of demonstrating this in practice
4.9 use a range of integrated skills and self-awareness to manage clinical challenges effectively in unfamiliar and unpredictable circumstances or situations
4.10 make decisions about the most appropriate care pathways for service users and refer service users appropriately
5.1 respond appropriately to the needs of all groups and individuals in practice, recognising that this can be affected by difference of any kind including, but not limited to, protected characteristics,* intersectional experiences and cultural differences
5.2 understand equality legislation and apply it to their practice
5.3 recognise the potential impact of their own values, beliefs and personal biases (which may be unconscious) on practice and take personal action to ensure all service users and carers are treated appropriately with respect and dignity
5.4 understand the duty to make reasonable adjustments in practice and be able to make and support reasonable adjustments in their and others’ practice
5.5 recognise the characteristics and consequences of barriers to inclusion, including for socially isolated groups
5.6 actively challenge these barriers, supporting the implementation of change wherever possible
5.7 recognise that regard to equality, diversity and inclusion needs to be embedded in the application of all HCPC standards, across all areas of practice
* The Equality Act 2010 defines the protected characteristics as age, disability, gender reassignment, race, religion or belief, sex, sexual orientation, marriage and civil partnership and pregnancy and maternity. Equivalent equality legislation in Northern Ireland protects age, disability, gender, race, religion or belief and sexual orientation.
6.1 adhere to the professional duty of confidentiality and understand when disclosure may be required
6.2 understand the principles of information and data governance and be aware of the safe and effective use of health, social care and other relevant information
6.3 recognise and respond in a timely manner to situations where it is necessary to share information to safeguard service users, carers and/or the wider public
6.4 understand the need to ensure that confidentiality is maintained in all situations in which service users rely on additional communication support (such as interpreters or translators)
6.5 recognise that the concepts of confidentiality and informed consent extend to all mediums, including illustrative clinical records such as photography, video and audio recordings and digital platforms
7.1 use effective and appropriate verbal and non-verbal skills to communicate with service users, carers, colleagues and others
7.2 communicate in English to the required standard for their profession (equivalent to level 7 of the International English Language Testing System, with no element below 6.5*)
7.3 understand the characteristics and consequences of verbal and non-verbal communication and recognise how these can be affected by difference of any kind, including, but not limited to, protected characteristics,** intersectional experiences and cultural differences
7.4 work with service users and/or their carers to facilitate the service user’s preferred role in decision-making, and provide service users and carers with the information they may need where appropriate
7.5 modify their own means of communication to address the individual communication needs and preferences of service users and carers, and remove any barriers to communication where possible
7.6 understand the need to support the communication needs of service users and carers, such as through the use of an appropriate interpreter
7.7 use information, communication and digital technologies appropriate to their practice
7.8 understand the need to provide service users or people acting on their behalf with the information necessary, in accessible formats, to enable them to make informed decisions
* The International English Language Testing System (IELTS) tests competence in the English language. Applicants who have qualified outside of the UK, whose first language is not English and who are not applying through the Swiss Mutual Recognition Route (SMR) must provide evidence that they have reached the necessary standard. More information is available here: Statement on English language proficiency requirements for internationally trained health and care professionals.
** The Equality Act 2010 defines the protected characteristics as age, disability, gender reassignment, race, religion or belief, sex, sexual orientation, marriage and civil partnership and pregnancy and maternity. Equivalent equality legislation in Northern Ireland protects age, disability, gender, race, religion or belief and sexual orientation.
8.1 work in partnership with service users, carers, colleagues and others
8.2 recognise the principles and practices of other health and care professionals and systems and how they interact with their profession
8.3 understand the need to build and sustain professional relationships as both an autonomous practitioner and collaboratively as a member of a team
8.4 contribute effectively to work undertaken as part of a multi-disciplinary team
8.5 identify anxiety and stress in service users, carers and colleagues, adapting their practice and providing support where appropriate
8.6 understand the qualities, behaviours and benefits of leadership
8.7 recognise that leadership is a skill all professionals can demonstrate
8.8 identify their own leadership qualities, behaviours and approaches, taking into account the importance of equality, diversity and inclusion
8.9 demonstrate leadership behaviours appropriate to their practice
8.10 act as a role model for others
8.11 promote and engage in the learning of others
9.1 keep full, clear and accurate records in accordance with applicable legislation, protocols and guidelines
9.2 manage records and all other information in accordance with applicable legislation, protocols and guidelines
9.3 use digital record keeping tools, where required
10.1 understand the value of reflective practice and the need to record the outcome of such reflection to support continuous improvement
10.2 recognise the value of multi-disciplinary reviews, case conferences and other methods of review
11.1 engage in evidence-based practice
11.2 gather and use feedback and information, including qualitative and quantitative data, to evaluate the response of service users to their care
11.3 monitor and systematically evaluate the quality of practice, and maintain an effective quality management and quality assurance process working towards continual improvement
11.4 participate in quality management, including quality control, quality assurance, clinical governance and the use of appropriate outcome measures
11.5 evaluate care plans or intervention plans using recognised and appropriate outcome measures in conjunction with the service user and revise the plans as necessary
11.6 recognise the value of gathering and using data for quality assurance and improvement programmes
12.1 understand the structure and function of the human body, together with knowledge of physical and mental health, disease, disorder and dysfunction relevant to their profession
12.2 demonstrate awareness of the principles and applications of scientific enquiry, including the evaluation of treatment efficacy and the research process
12.3 recognise the role(s) of other professions in health and social care and understand how they may relate to the role of paramedic
12.4 understand the structure and function of health and social care systems and services in the UK
12.5 understand the theoretical basis of, and the variety of approaches to, assessment and intervention
12.6 understand human anatomy and physiology and development across the lifespan, sufficient to recognise the nature and effects of injury or illness, and to conduct assessment and observation in order to form a differential diagnosis and establish service user management strategies
12.7 understand the following aspects of biological science:
- disease and trauma processes and how to apply this knowledge to develop appropriate treatment plans for the service user’s care;
- how the application of paramedic practice may cause physiological and behavioural change;
- human anatomy and physiology, especially the dynamic relationships of human structure and function, and the musculoskeletal, cardiovascular, respiratory, digestive, endocrine, urinary, reproductive, integumentary and nervous systems;
- human growth and development across the lifespan;
- normal and altered anatomy and physiology throughout the human lifespan;
- relevant physiological parameters and how to interpret changes from the norm;
- the factors influencing individual variations in human ability and health function;
- the main classes of pathogenic microorganisms, the spread of infection and the use of universal precautions; and
- the main sequential stages of normal development, including cognitive, emotional and social measures of maturation through the human lifespan
12.8 understand the following aspects of physical science:
- principles and theories of physics, biomechanics, electronics and ergonomics that can be applied to paramedic practice;
- understand scientific units of measurement acquired in clinical and healthcare practice and the principles of analysis and interpretation;
- the means by which the physical sciences can inform the understanding and analysis of information used to determine a diagnosis;
- the pathophysiological changes to normal homeostatic function and its implications; and
- the principles and application of measurement techniques based on biomechanics and electrophysiology
12.9 understand the following aspects of sociological, health and behavioural science:
- how aspects of sociology, health and behavioural sciences are fundamental to the role of the paramedic in developing and maintaining effective relationships; and
- recognise how sociology can inform an understanding of physical and mental health, illness and healthcare in the context of paramedic practice
12.10 understand the following aspects of clinical science:
- pathological changes and related clinical features of conditions encountered in emergency and urgent care and primary and community care;
- physiological, pharmacological, structural, behavioural and functional changes in service user presentation;
- principles of evaluation and research methodologies which enable the integration of theoretical perspectives and research evidence into the design and implementation of effective paramedic practice;
- the theoretical basis of assessment, clinical decision-making and appropriate treatment plans, along with the scientific evaluation of their effectiveness; and
- the theories supporting problem-solving and clinical reasoning
12.11 understand the pharmacological principles applied to healthcare which include pharmacodynamics and pharmacokinetics and apply to those medicines utilised by paramedics to treat service users.
- the role of pain management, its complexity and the importance of robust approaches using both pharmacological and pharmacological strategies;
- the analysis of polypharmacy, evaluating pharmacological interactions and the impact upon mental wellbeing and healthcare provision; and
- recognise adverse drug reactions and manage appropriately, including reporting as required
12.12 understand human development and the main sequential stages of normal development, including cognitive, emotional and social measures of maturation through the human lifespan.
- recognise human growth and development including factors influencing individual variations in human ability and health status;
- evaluate how variation influences susceptibility to disease, injury and responses to treatment across the lifespan;
- understand the role of nutrition in promoting health and illness across the lifespan; and
- understand the fundamentals of genetics
12.13 understand the effects of psychological factors on health and illness and the impact of culture on illness
- recognise the contribution of behavioural factors in health and illness; and
- understand the basic knowledge of the key theories of behavioural change to include the principles of cognitive behavioural therapy and motivational interviewing
12.14 understand and evaluate social determinants of health, including inequality and factors contributing to the needs of different social groups, and the factors that influence an individual in health and illness.
- recognise how sociological, health and behavioural sciences are fundamental to the role of the paramedic in developing and maintaining effective relationships; and
- recognise how sociology can inform an understanding of physical and mental health, illness and healthcare in the context of paramedic practice
13.1 change their practice as needed to take account of new developments, technologies and changing contexts
13.2 gather appropriate information
13.3 analyse and critically evaluate the information collected
13.4 select and use appropriate assessment techniques and equipment
13.5 undertake and record a thorough, sensitive and detailed assessment
13.6 undertake or arrange investigations as appropriate
13.7 conduct appropriate assessment or monitoring procedures, treatment, therapy or other actions safely and effectively
13.8 recognise a range of research methodologies relevant to their role
13.9 recognise the value of research to the critical evaluation of practice
13.10 critically evaluate research and other evidence to inform their own practice
13.11 engage service users in research as appropriate
13.12 know the theories and science that underpin the theory and principles of paramedic practice
13.13 know the indications and contra-indications of using specific paramedic techniques in emergency and urgent care and primary and community care, including their limitations and modifications
13.14 ensure decision-making is supported by effective safety-netting
13.15 modify and adapt practice to meet the clinical needs of service users within the emergency and urgent care environment
13.16 know how to select or modify approaches to meet the needs of service users, their relatives and carers, when presented in the emergency and urgent care environment
13.17 formulate specific and appropriate management plans including the setting of appropriate timescales
13.18 conduct a thorough and detailed physical examination of the service user, using appropriate skills to inform clinical reasoning and guide the formulation of a differential diagnosis across all age ranges
13.19 use observation to gather information about the functional abilities of service users, how this affects the management of patients and the appropriate patient care pathways
13.20 understand the need to consider the assessment of both the health and psychosocial care needs of service users and carers
14.1 understand the need to maintain the safety of themself and others, including service users, carers and colleagues
14.2 demonstrate awareness of relevant health and safety legislation and comply with all local operational procedures and policies
14.3 work safely, including being able to select appropriate hazard control and risk management, reduction or elimination techniques, in a safe manner and in accordance with health and safety legislation
14.4 select appropriate personal protective equipment and use it correctly
14.5 establish safe environments for practice, which appropriately manage risk
14.6 understand and be able to apply appropriate moving and handling techniques
14.7 understand, and be prepared for, the responsibilities of the paramedic in responding to hazardous or major incidents, including public health emergencies
14.8 establish and run a triage system
14.9 understand the use and importance of effective communication in major incidents
14.10 demonstrate an understanding of the need for business continuity, escalation and resilience plans
15.1 understand the role of their profession in health promotion, health education and preventing ill health
15.2 understand how social, economic and environmental factors (wider determinants of health) can influence a person’s health and wellbeing
15.3 empower and enable individuals (including service users and colleagues) to play a part in managing their own health
15.4 engage in occupational health, including being aware of immunisation requirements
We first published standards of proficiency for paramedics in July 2003.
We review the standards regularly to look at how they are working and to check whether they continue to reflect current practice in the professions we regulate. Our most recent review began in 2019 and included a formal consultation and close collaboration with key stakeholders, registrants and professional bodies. The revised sets of standards for all 15 professions were formally approved by our Council in March 2022 and came into effect on 1 September 2023.
The profession-specific standards for paramedics were developed with the input of the relevant professional bodies and the views of stakeholders during our consultation work. We are confident that the standards are fit for purpose and reflect safe and effective professional practice for paramedics.
As part of our commitment to ensuring the standards remain relevant to current professional practice, will continue to listen to our stakeholders and keep the standards under regular review.
This may result in updates to the standards in future, which may include corrections, amendments or changes to ensure the standards remain relevant.
This is a crucial component in fulfilling our purpose to promote excellence in the professions we regulate, and championing high quality care that the public can access safely and with confidence.
This document contains minor amendments to typographical errors, meaning it may differ slightly from previous versions published on our website.
The publication code for these standards is 20230901POLPUB PASoP.
On 1 September 2023 the updated standards of proficiency came into in effect, which included changes to the standards for all professions and changes to profession-specific standards.
To see the changes between the previous and updated sets of standards, download the comparison table for paramedics.
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- Professional standards