Driving professionalisation in paramedicine: An international qualitative study of key facilitators

Background: Paramedicine is in the midst of a global shift towards professionalisation, marked by advances in education, regulation, and integration within healthcare systems. While barriers to this process have been well described, less is known about the facilitators that enable progress. Aim: This study explores key facilitators of paramedic professionalisation across five high-income healthcare systems. Methods: Semi-structured interviews were conducted with 15 stakeholders, including clinicians, educators, policymakers, and leaders, from the United Kingdom, Ireland, Canada, Australia, and the United States. Interviews were conducted online, recorded, transcribed verbatim, and analysed thematically within a critical theory framework. Results: Six themes were identified: 1. The evolution and expansion of paramedic roles, including specialisation and increased autonomy. 2. Community paramedicine as a catalyst for integration and preventative care. 3. Professionalisation and recognition through advanced education, regulation, and career pathways. 4. Socio-political, Governance and Leadership Enablers. 5. Interprofessional collaboration and strong professional leadership. 6. The impact of Coronavirus Disease 2019 (COVID-19) as an accelerator of change, highlighting opportunities for innovation, research, and lifelong learning. Conclusion: Facilitators of professionalisation include political investment, regulatory reform, educational advancement, and collaborative leadership. Harnessing these enablers is essential for embedding paramedics as integral healthcare professionals. Together with companion work on barriers, this analysis provides an understanding of the challenges and opportunities shaping the future of paramedicine.