Three in 20 ambulances reaching patients with a life-threatening emergency have no paramedic as part of their crew in large parts of the country, an HSJ analysis of the latest data has discovered.
Figures show that in the five months from April this year, at least 27,000 category 1 incidents – the most serious type, which include suspected cardiac and respiratory arrests – were first attended by a crew without a registered paramedic.
However, the data also shows the number of ambulances attending category one calls without paramedics has also fallen for the fourth consecutive year, with particularly steep falls in the worst-affected areas. There is also less variation across the country.
Both the East of England and East Midlands ambulance service trusts had non-paramedic crews first on scene at more than 15 of category 1 incidents in this time.
There is no rule requiring a paramedic to be on board, and in some cases the first attending vehicle is a “community first responder” or “rapid response” vehicle. These are sometimes used more often in rural areas, for a quick response, and are often followed up by full crews.
However, inquests have led to warnings about the risks of relying on non-registered crews.
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Source: HSJ, 3 November 2026
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