Failure to authorise newly qualified paramedics and  advanced paramedics to practice

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The Irish Society of Paramedicine (ISP) is deeply concerned about the treatment of newly qualified paramedics and advanced paramedics (AP) within the National Ambulance Service (NAS). 

We have been contacted by multiple graduates from PD19 and PD20 and APs who, despite successfully completing their studies, internships, and being officially registered as Paramedics/Advanced Paramedics on the Pre-Hospital Emergency Care Council (PHECC) register, are being denied authorisation to practice as fully qualified practitioners. 

Historically, the process of issuing new letters of authorisation to practice on behalf of the Clinical Director, and updating status on internal NAS systems, has been routine and efficient. For years, this system has served both staff and the service well. 

Now, however, regional ECAOs have been directed to stop issuing these authorisations. As a result, newly qualified paramedics remain in professional limbo — fully trained, fully registered, yet barred from functioning in their role. 

This is not just unfair to the graduates; it is deeply damaging to the NAS and the public it serves. The service is already on its knees, with dangerously high call volumes, inappropriate use of emergency ambulances on nearly every shift, and staff pushed to breaking point. At a time when every paramedic and advanced paramedics are urgently required on the frontline, the NAS has inexplicably chosen to sideline those who are ready and able to contribute. 

 We demand immediate answers to the following: 

 1. Why has this process been disrupted without consultation or explanation? 

 2. Who is now responsible for issuing the necessary letters of authorisation? 

 3. When will these graduates be formally privileged to practice, as is their right under PHECC registration? 

Delays of this nature are indefensible. They undermine morale, threaten retention, and risk patient safety by leaving ambulances short-staffed while qualified personnel remain idle. 

The Irish Society of Paramedicine calls on NAS management, the HSE and the Department of Health to act without delay. Graduates have earned the right to practice. The public needs them. The service needs them. Withholding that authorisation is unjustifiable.