magpas   DEDICATED VOLUNTEER LIFESAVERS

The Emergency Medical Team (EMT) is a specialist pre-hospital response and retrieval team who have undertaken specific training for the role and are equipped to provide the full range of pre-hospital medical interventions. The team comprises a volunteer doctor and a volunteer paramedic drawn from a pool of appropriately trained individuals.

The paramedics are volunteers from the East of England Ambulance NHS Trust. The team is trained to provide:

• On-scene medical support
• On-line medical support
• Special incident medical support
• Major incident medical support


The EMT is based centrally at the Cambridgeshire Constabulary Air Operations Unit in RAF Wyton. When appropriate, it uses the police helicopter or the new Air Ambulance (Anglia 2).

It is activated via the control rooms of either the East of England Ambulance Service, Cambridgeshire Fire and Rescue Service or Cambridgeshire Constabulary.

This refers to deployment to the scene of an incident to provide direct medical support. On-scene medical support may involve the full spectrum of pre-hospital critical care at the scene as well as in transit care during the journey to the most appropriate hospital. On-scene support most commonly involves major trauma patients who are trapped at the scene.

The EMT will however respond to any request from an Ambulance Crew or Fire Officer for assistance at the scene of an incident. In practice, the EMT is deployed between 1 and 5 times a day.

There are two main ways the EMT can be activated:

(i) An automatic paging system has been developed with the Ambulance Service.

(ii) Direct telephone or radio contact from Ambulance Control.

The EMT also has the authority to ‘self activate’ on the basis of information received over the radio or from other sources. Again, the team will typically contact Ambulance, Fire and Police control to seek further information as they deploy. Although the principle control function lies with Ambulance Control, these alternative and ‘backup’ systems ensure than no important incidents are missed.

All members of the Emergency Medical Team become members of Magpas. They are provided with third party liability and personal injury insurance (full details can be obtained from the Magpas office). Individual doctors must also be members of a medical defence organisation and they must inform that organisation of the nature and extent of their immediate care activity. Magpas has considerable experience of this and none of our volunteer doctors have ever had an additional premium added to their policy on the basis of Magpas activity.

East of England Ambulance NHS Trust paramedics are indemnified by the Clinical Negligence Scheme for Trusts when they undertake duties on behalf of the Trust. Volunteer duties with the EMT are currently considered by the Trust as equivalent to normal Ambulance Service duties. Any interventions the paramedics may undertake on the EMT which are beyond the normal scope of practice of a Trust employee are undertaken under direct medical supervision and, where necessary, instruction and thus remain the responsibility of the Magpas EMT doctor.

Since its inception in 1971, Magpas has set the standard for the conventional model of an Immediate Care Scheme. This initially involved a large number of locally based volunteer doctors (typically General Practitioners) who agreed to undertake some training and carry additional equipment. As Magpas and the NHS Ambulance Service have evolved, many volunteer doctors now come from hospital backgrounds such as Emergency Medicine or Anaesthetics.

Having a centrally based team made up of a doctor and paramedic has given greater consistency of coverage and a higher level of clinical intervention at the scene.

The entry criteria for doctors are:

(i) Fully Registered Medical Practitioner who is also licensed to practice medicine.

(ii) Four years post-registration experience. At least 4 months of this should be in the practice of Emergency Medicine or Critical Care.

(iii) Diploma in Immediate Medical Care (Dip IMC) of the Royal College of Surgeons of Edinburgh. Doctors who are prepared to commit themselves to the EMT Training Programme but who do not have the Diploma may join the training programme provided that they undertake to complete the Diploma within 18 months of completing the EMT Course. Support is provided for this.

(iv) Documented evidence of pre-hospital care experience is desirable.

(v) Provider status in ALS, APLS and MIMMS is desirable.

(vi) Commitment to the Emergency Medical Team as evidenced by a written undertaking to complete the entire EMT Training Programme

(vii) Successful completion of the EMT Course

Paramedics are integral to the EMT concept and they are expected to play a full part in the EMT Training Programme. They are not simply there to assist the doctor. Magpas therefore has high expectations of the paramedics and expects them to complete the same training programme as the doctors.

The entry criteria for paramedics are:

(i) State Registered Paramedic who is currently employed by the East of England Ambulance NHS Trust.

(ii) Four years post registration experience.

(iii) Commitment to the Emergency Medical Team as evidenced by a written undertaking to complete the entire EMT Training Programme

(iv) Diploma in Immediate Medical Care (Dip IMC) of the Royal College of Surgeons of Edinburgh. Paramedics who are prepared to commit themselves to the EMT Training Programme but who do not have the Diploma may join the training programme provided that they undertake to complete the Diploma within 18 months of completing the EMT Course.

(v) Provider status in PHTLS, PHPLS (or PEPP) and MIMMS is desirable

The East of England Ambulance NHS Trust runs MIMMS courses and has in the past provided financial support for paramedics who wish to undertake the Diploma in Immediate Medical Care. EMT paramedics are encouraged to take the Diploma during the EMT Training Programme. Magpas provides a diploma preparation course for EMT Paramedics and Doctors.

There is considerable demand from both doctors and paramedics. The charity therefore gives priority to those doctors and paramedics who most closely fulfil the entry requirements and who make an early commitment to the EMT concept and Training Programme. Each application will however be considered on its own merits.

In order that applicants are fully aware of the EMT operations and the commitment involved, all those interested will be asked to undertake observing with a duty EMT for a set amount of time before a formal application is submitted. There is no obligation to apply to the EMT if after observing the Team applicants do not wish to join. As well as observing, the applicants take part in a selection day, involving an interview, a simulation scenario, and a knowledge review.

The EMT course is designed to allow doctors and paramedics to develop their skills and demonstrate all of the core competencies covered in the Magpas Competence Framework for Pre-hospital and Retrieval Medicine please contact the office, on Info@magpas.org.uk, or telephone 01480 371062 for more details.

In terms of CME or PGME credits for General Practitioners and Career Grade doctors, the course has been accreditied by the College of Emergency Medicine, the royal College of Anaesthetists and the Faculty of Pre-hospital Care of the Royal College of Surgeons of Edinburgh, please contact the office, on Info@magpas.org.uk, or telephone 01480 371062 for more details.

For a detailed answer to this question, please contact the office, on Info@magpas.org.uk, or telephone 01480 371062.

RAF Wyton (near Huntingdon and St Ives) is centrally situated for Cambridgeshire and Bedfordshire. Experience has shown that with all types of deployment (land and air) it is possible to get anywhere in the area within 30 minutes. Often, it is possible to get there in less time and still undertake critical (in some cases lifesaving) interventions. The Magpas doctors who historically travelled long distances have reported many anecdotal experiences where they arrived in good time to perform meaningful interventions or facilitate extrication and triage.

There is little doubt that once the staffing of the EMT is guaranteed, the primary mode of delivery should be by helicopter. Magpas is currently working alongside the Police, the East of England Ambulance NHS Trust and the East Anglian Air Ambulance charity to provide the primary HEMS system for the region.

The current Magpas constitution allows for the provision of immediate care in the immediate areas surrounding Cambridgeshire and Bedfordshire and there is no reason why this cannot continue. Requests for assistance further afield would have to be carefully reviewed by the duty Emergency Medical Team and the availability of helicopter transfer (and retrieval) would need to be taken into account.

There are parallels in other parts of the UK and Europe which many people are familiar with. In the UK, the Birmingham CARE car is manned by volunteer Diploma level immediate care doctors from a very wide area and is available on weekends only. It is manned by a doctor / nurse / paramedic team and responds to any serious illness or injury. The Liverpool based ATACC team operate in a similar way. The Great North Air Ambulance and a number of other air ambulance operations have developed elements of medical staffing. The London HEMS service is the only pre-hospital service which directly employs doctors to provide a full time pre-hospital care response.