FOI 26-233 Advanced Paramedics
Freedom of Information Request
- Reference
- FOI 26-233 Advanced Paramedics
- Request Date
- 18 May 2026
- Response Date
- 04 Jun 2026
- Information Requested
Specifically, I am interested in clinical staff typically employed at Band 7 or Band 8 (or equivalent), such as (but not limited to) Specialist Paramedics, Advanced Paramedics, or Advanced Clinical Practitioners. Please could you provide the following information:
- Roles and Structure Do you employ Band 7 or Band 8 (or equivalent) clinical staff in roles such as Specialist Paramedic, Advanced Paramedic, Advanced Clinical Practitioner, or equivalent? If so, what titles are used within your organisation?
- Prescribing Capability Are these clinicians qualified as independent prescribers? If yes: How is prescribing undertaken in practice (e.g. face-to-face, remote prescribing, use within EOC/control room, etc.)? If no: Do they utilise Patient Group Directions (PGDs), please supply a copy of anyadditionalPGD’s over and above that used by a regular paramedic PGDs?
- Deployment and Dispatch How are these clinicians dispatched to incidents? For example: via standard dispatcher allocation, clinician-led triage within EOC, self-dispatch, or other methods such asparticular triageoutcome codes? Are they primarily dispatched to emergency incidents, referrals, or a mixture?
- Referral Pathways Do you provide direct referral pathways to these clinicians for external services, such as: Care/residential homes GP surgeries Prisons Other healthcare providers If so, please briefly describe how these referrals are accessed and managed.
- Role Activity and Responsibilities How is their working time typically divided between: Patient-facing duties (face-to-face or remote) Emergency Operations Centre (EOC) or control room work Training and supervision Leadership or management responsibilities Do these roles include formal leadership or supervisory responsibilities? If so, please outline.
- Utilisation and Workload What are the average utilisation figures for these clinicians across the Trust? Specifically, on average: How many patients are seen face-to-face per shift by these clinicians? (If easier, please provide equivalent workload metrics used internally
- Response
Q1 - The Scottish Ambulance Service employs Advanced Practitioners in Urgent and Primary Care (APUPCs), who are appointed at Band 7. The Scottish Ambulance Service no longer employs staff under the title of Specialist Paramedic.
Further general information relating to Advanced Practitioner roles is publicly available on our website and can be accessed here: Advanced Practitioner
Q2 - Qualified Advanced Practitioners in Urgent and Primary Care (APUPCs) are independent prescribers.
Prescribing may be undertaken in practice in a range of settings, including:
- Face-to-face consultation when working as a solo responder
- Collaborative working within Primary Care settings
- Remote consultation, including telephone or video-based assessment
During the second year of the training programme, APUPCs utilise a suite of Patient Group Directions (PGDs). The following list provides an indication of the medicines covered:
Aciclovir; Amoxicillin (250mg and 500mg); Cetirizine; Chloramphenicol eye ointment; Chlorphenamine 4mg tablets; Clarithromycin (250mg and 500mg); Clotrimazole; Co‑amoxiclav (625mg); Co‑codamol (30mg/500mg); Codeine phosphate 30mg; Diclofenac sodium (75mg ampoules and 50mg tablets); Doxycycline; Flucloxacillin (250mg and 500mg); Hydrocortisone 1% cream; Hyoscine butylbromide ampoules (end of life care); Ibuprofen (200mg and 400mg); Lidocaine ampoules; Loperamide; Metronidazole; Morphine oral solution; Nitrofurantoin 100mg; Nystatin; Omeprazole 20mg; Oral rehydration salts; Paracetamol 500mg tablets; Phenoxymethylpenicillin; Prednisolone 5mg tablets; Prochlorperazine (ampoules and tablets); Salbutamol inhaler; Senna.
Please see the attached folder containing redacted PGD’s. The redacted information is exempt from release under section 38(1)(b) personal information.
Q3 - APUPCs are deployed through a combination of clinician-led dispatch and standard dispatcher allocation. They are typically allocated to incidents that enter the system as emergency calls and may respond to a mixture of emergency work and clinically appropriate cases identified through triage.
Q4 - APUPCs utilise the same local referral pathways available to all frontline clinicians, with potential for enhanced referral or admission rights depending on local agreements.
Referral pathways are supported through:
- The SAS Pathways Hub, which assists clinicians in identifying and accessing appropriate services
- Local Flow Navigation Centres, operated by territorial Health Boards, which provide additional support for onward referral
These pathways enable clinicians to refer patients to appropriate services such as primary care, community services, or other healthcare providers where suitable.
Q5 - APUPCs undertake a mix of clinical and system-support roles. Their working time is typically divided as follows:
- Approximately 20% in Primary Care or similar collaborative settings
- Up to 30% undertaking remote consultation and/or supporting the Advanced Practitioner dispatch function within the Ambulance Control Centre
- The remaining time responding as a solo responder to 999 calls, delivering face-to-face patient care
These roles focus primarily on advanced clinical practice and service delivery. While practitioners may support colleagues and contribute to system-wide decision-making, formal leadership or supervisory responsibilities are not a defining feature of all posts and may vary depending on individual roles.
Q6 - The Scottish Ambulance Service does not hold centrally recorded or standardised information on utilisation metrics for Advanced Practitioners in Urgent and Primary Care (APUPCs), such as average numbers of patients seen per shift across the Service.
In accordance with section 17 of the Freedom of Information (Scotland) Act 2002, this information is not held.
While some indicative information may be available at a local or individual level, there is no requirement under FOISA for a public authority to create new information or to collate data in order to respond to a request. As such, we are unable to provide standardised utilisation figures of the type requested.
However, by way of general context, and recognising that activity will vary depending on factors such as location, shift length, and operational demand, Advanced Practitioners may typically see between 4 and 10 patients per shift in a face-to-face capacity.
This contextual information is not held as part of a formal dataset and should be considered indicative only.
- Response Documents
