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Ambulances are to be sent to 999 emergency calls without any paramedics.

Yorkshire Ambulance Service NHS Trust (YAS) has said from tomorrow it will allow two Emergency Care Assistants (ECA) to attend urgent incidents as first responders.

ECAs are not clinically trained and cannot administer any medication. Paramedics and union leaders say the plan threatens patient safety and have threatened industrial action.

The controversial ECA role was brought in by YAS in early 2013 to support paramedics and higher skilled Emergency Care Practitioners (ECP), primarily through driving ambulances and performing non-clinical tasks.

But YAS now says it is “common sense” to extend the role to allow ECAs to attend accidents and emergencies alone.

One paramedic, who wanted to remain anonymous, said: “After years of cost cutting and ignoring warnings from both staff and unions Yorkshire Ambulance Service has found itself in a position of not having enough qualified staff to provide a safe level of cover.

“It has taken the decision to despatch emergency ambulances with no qualified clinicians on to life-threatening emergencies. To members of the public they will look the same as they wear the same uniform and drive the same ambulances.

“ECAs are trained in basic first aid and are allowed to do basic life support (CPR). But they are not trained or allowed to assess or treat patients, not even with paracetamol.”

The source said the move was “by far the most worrying”. The ECA staffed ambulances would be sent to “Red” rated calls – ones that require a response within eight minutes.

They added: “I am a paramedic of more than 10 years and have witnessed many downturns in the ambulance service that have compromised both staff and the public but this is by far the most worrying.

“I would not let one of these ambulances with two ECA attend any of my relatives. I would want someone who could intervene, treat and save my relative’s life.

“I would not want to stand there and watch as the unqualified, untrained, inadequate ambulance response did nothing but watch with me, as my relative worsened and possibly died.”

Ray Gray, Unison’s regional officer for YAS, said: “This happened early on when they brought ECAs in and Unison stepped in and stopped it. But if they’re doing it again that’s against the agreement we have.”

Union chiefs from Unison, which represents about 3,000 of the 4,000 workers at the service, say YAS agreed to provide extra training to ECAs in a bid to bring 68 per year up to band 4 level, the same as an ECP. But Unison says it would take 10 years to bring all the ECAs up to band 4.

Mr Gray said YAS had axed the band 4 level medics a few years ago.

“We think getting them back is a priority but the Trust don’t share that view,” he added.

“They’re £12m overspent and we appreciate there’s problems balancing the budget but we’ve got to think about patient safety.”

YAS already operates a Community First Responder (CFR) scheme to allow volunteers to begin life-saving treatments. CFRs can use automated defibrillator machines and apply oxygen masks. Unison has advised ECAs to defy YAS management and not respond to Red calls alone.

Ambulance chiefs have defended the decision to send Emergency Care Assistants to 999 calls unsupported by paramedics.

David Whiting, Chief Executive at Yorkshire Ambulance Service NHS Trust, said: “Patients’ needs are at the heart of everything we do and our absolute focus is to ensure that we continue to deliver a safe, responsive and high quality service to our patients.

“Developments to the Emergency Care Assistant (ECA) role formed part of a wider package which was discussed with Unison earlier this week and although they felt unable to agree to the changes as a whole, they did indicate that they were satisfied with this element of the proposal.

“The developments to the ECA role are well within their capability following their training and are also consistent with how other ambulance services operate across the country. As the primary role of the ECA is to work in a clinical support capacity alongside a fully-trained clinician, there will be very few occasions where they will be required to fulfil this additional element of their role.

“Along with many of our staff, we feel this is a positive move which allows us to fully utilise the skills of our ECAs and further improve the responsiveness of our service and the care we provide to patients. It also provides an opportunity for these staff to progress.

“We are committed to finding ways in which we can make things better for both our patients and our workforce and we will continue to work with our staff to do this.”

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