An emergency care assistant is a type of emergency medical service worker in the United Kingdom, often used to support paramedics in responding to emergency calls.[1]

This frontline staff role was introduced in 2006 as part of the modernisation of NHS emergency ambulances and also to lower costs. By 2011 there were 2000 people working as ECAs in the United Kingdom.[2] The role has varied scope across the country, as it is defined by the local ambulance service policy, although the role primarily involves assisting ambulance clinicians. ECAs are typically trained with emergency driving skills.[1] They may carry out basic diagnostic procedures under the direct supervision of a paramedic.[3] The College of Paramedics does not expect ECAs to be required to make complex clinical decisions.[4]


Each regional ambulance service determines its own criteria around what is needed to become an ECA.[3] They are amongst the lowest paid front line staff in the NHS, typically being paid at AfC band 3 or 4.[5]

Ambulance crew unions and a range of healthcare professionals have expressed reservations about having ambulance services employ a large number of ECAs, both before and after the change.[6][7][8] Unions representing ambulance workers had fears that the workforce changes could lead to an increase in the risk to patients as well as adding to the workload of paramedics[9][10][11] and had written to East Midlands Ambulance Service to ask for the reintroduction of the technician role.[12]

Another issue is the amount of driving an ECA has to do during a 12-hour shift, as driving time regulations do not apply to emergency services. Whilst either of the crew members may drive when responding to an emergency case, the paramedic is more likely to attend a patient during an emergency transport, meaning that the ECA is likely to do more driving.

In December 2014, after a steep rise in the number of paramedics on long term sick leave suffering stress, Yorkshire Ambulance Service said they would be bringing back the technician role.[13]

Career development

There is a route for some ECAs to progress to Technician level. A training programme is run by the East of England Ambulance NHS Trust (EEAST) which aims to help ECAs progress to technician within 1 year of their basic training; by November 2015, most ECAs working for the East of England Ambulance Service NHS Trust (EEAST) have made the transition from ECA to Technician on this programme.[14]

ECAs who wish to progress to become a paramedic will need to complete a University degree,[15] Some employers do provide structured training to support this, with an expectation that it would take at least two and a half years for an ECA to complete this on a part-time basis.[16]


  1. ^ a b "Careers in the ambulance service: Emergency care assistant". NHS Careers. Retrieved 3 October 2014.
  2. ^ Rainey, Sarah; Adams, Stephen (7 November 2011). "Emergency Care Assistants replace paramedics for 999 calls as cuts hit ambulance trusts". The Daily Telegraph. Telegraph Media Group. Archived from the original on 7 November 2011. Retrieved 15 January 2015.
  3. ^ a b "Job profiles:Emergency care assistant". National Career Service (UK). Retrieved 12 January 2015.
  4. ^ Andalo, Debbie (20 February 2013). "How to get ahead in … the paramedic service". The Guardian. Guardian Media Group. Retrieved 10 February 2015.
  5. ^ "National profiles for ambulance services" (PDF). NHS Employers. Retrieved 22 January 2015.
  6. ^ "Emergency cover changes confirmed". BBC News. BBC. 25 January 2005.
  7. ^ "Ambulance crews' anger at changes". BBC News. BBC. 9 May 2007.
  8. ^ Triggle, Nick (11 December 2007). "Ambulance shake-up 'poses risks'". BBC News. BBC.
  9. ^ "Unison angry over training scheme". BBC News. BBC. 7 August 2008.
  10. ^ "Volunteers relied on as 999 crews". BBC News. BBC. 9 November 2009.
  11. ^ "Yorkshire Ambulance Service proposes workforce changes". BBC News. BBC. 7 January 2013.
  12. ^ "East Midlands ambulance union criticises staff policy". BBC News. BBC. 19 March 2013.
  13. ^ "Emergency cover changes confirmed". BBC News. BBC. 19 December 2014.
  14. ^ "Chelmsford lifesaver first in Mid-Essex to complete enhanced lifesaving skills course" (Press release). East of England Ambulance Service NHS Trust (EEAST). 25 November 2014. Archived from the original on 11 February 2015. Retrieved 11 February 2015.
  15. ^ "Become a paramedic". College of Paramedics. Retrieved 12 January 2015.
  16. ^ "ECA To Paramedic Frequently asked Questions". East Midlands Ambulance Service. June 2014. Retrieved 22 January 2014.