If you phone for emergency medical assistance, you would think and hope that there is some sort of minimum set who will actually respond to your call for help.
Call in Germany, and you will be guaranteed that the arriving ambulance is staffed with at least one Rettungsassistent (see paragraph 25 of the Durchführungsverordnung HRDG vom 3. Januar 2011, this is for the state of Hesse).
Call in England, and…well…you might get a Paramedic, or a Technician, or both, or an Emergency Care Support Worker, all three, a mix…it’s up to the individual service. All I could find was the Health and Social Act (Regulation 22), which merely states:
In order to safeguard the health, safety and welfare of service users, the registered person must take appropriate steps to ensure that, at all times, there are sufficient numbers of suitably qualified, skilled and experienced persons employed for the purposes of carrying on the regulated activity.
To me, that reads a little like “if you can get by, then you’ll be alright”.
It’s high time for some research to be done in to this (I’ve just started), to ensure that skill levels when staffing frontline ambulances are evidence based, that they are cost effective, that they can deliver the care when and where they are needed. In other words: When a patients needs help, they get the help they need.