The current state of South African emergency medical services’ training

By Oliver Wright, chief executive officer, South African Private Ambulance and Emergency Services Association (SAPAESA)

On 4 November 2014, the then Minister of Health, Dr Aaron Motsoaledi, published Government Notice Number R870, which notified the public of his intention to close the registers at the Health Professions Council of South Africa (HPCSA) to future graduates of the Basic Ambulance Assistant, Ambulance Emergency Assistant and Critical Care Assistant qualifications.

The closure of these registers was to make way for graduates of the National qualifications framework (NQF)-aligned Emergency Care Assistant, Diploma Paramedic and Emergency Care Practitioner qualifications to be the foundation for Emergency Medical Services (EMS) qualifications going forward.

While it is generally acknowledged that the alignment of Emergency Medical Services qualifications to the National Qualifications Framework was an important step forward in the future of EMS training, the manner in which the matter was handled by the relevant organisations left a lot to be desired.

Little effort was made by the Department of Health or the HPCSA to allow for pathways for practitioners registered as Basic Ambulance Assistants, Ambulance Emergency Assistants and Critical Care Assistants to migrate onto the updated qualifications framework. The result was the graduates on these qualifications were left with very little option to upskill themselves and develop themselves within the emergency medical service industry, unless they were to start new educational programmes according to the NQF-aligned qualifications, right from the beginning.

Further, there appears to have been no planning done to ensure that there were enough accredited training institutions in place to ensure that sufficient volumes of graduates of the Emergency Care Assistant, Diploma Paramedic and Emergency Care Practitioner qualifications would be available to meet the staffing requirements of the both the provincial and private emergency medical services sectors, before the termination of the Basic Ambulance Assistant, Ambulance Emergency Assistant and Critical Care Assistant qualifications took place.

Essentially, the Department of Health and the HPCSA put a stop to a training methodology that was meeting the employment and operational demands of the emergency medical services sector, without first ensuring that continuity from the historical training methodology to the NQFaligned methodology.

The Department of Health assured the industry that distance and parttime learning would be available to potential students wishing to enrol

for Emergency Care Assistant and Diploma Paramedic qualifications, in order to facilitate education for students who were not able to study on a part-time basis. To date, neither part-time, nor distance learning courses have materialised.

The result of these failures by the Department of Health as well as the HPCSA has resulted in a critical shortage of emergency medical services staff members across the country.

South Africa was already faced with a severe shortage of ambulances, servicing a vast population spread across both urban and rural environments. This shortage of ambulances has only grown worse since the termination of the historic training methodology within the South African emergency medical services sector.

South Africa needs to ensure that additional tertiary training institutions are accredited to offer training of the Emergency Care Assistant, Diploma Paramedic and Emergency Care Practitioner qualifications and that both distance and part-time learning is available as a matter of the highest priority.