Why would you recommend your career to a young person?
We are a trusted profession that now works in so many different settings – primary care, secondary care, hospice, event medicine, expedition medicine, and even offshore power. Paramedics graduating today can choose a career that can flex, and adapt to the other parts of their life.
There is no longer a single default employer, and paramedics can build portfolio careers that span clinical practice, leadership, education, and research. The profession can even take you around the world – in the armed forces or on a cruise ship.
As one of the Allied Healthcare Professions (AHP) we are part of the third largest group of staff in the NHS and are now better represented in national policy and guidance than ever before.
What did you want to be when you were growing up?
I have always been drawn to engineering, so I assumed that I would end up doing something in this space. I am interested in the blend of form and function – Meccano and Lego were early daily playthings and this evolved to building go-karts and fixing bikes, and eventually maintaining cars.
Why did you change your mind?
After leaving school I got a summer job as a porter in the local hospital and became fascinated with healthcare. This led to me not going to college that year (much to my parents' consternation) on the basis that I could save some money and go next year. That was 1989…..
What qualities do you think you need to do your job well?
Compassion, patience, resilience, courage, focus, integrity, insight, and energy.
What are the main 3 factors that make you frustrated at work?
Resistance to change – despite evidence for the need
Hierarchies and structures that stifle the voices of patients and staff
Fragmentation and incompatibility of systems – IT, people, and processes.
What was your best career move?
Spending two years on secondment as a national investigator at the Healthcare Safety Investigation Branch (HSIB), which conducts investigations to identify factors that may have harmed or could harm patients during NHS care.
Using my clinical skills alongside emerging knowledge in safety science and systems thinking has really helped me understand the importance of how we approach system design and patient safety in healthcare through better analytical techniques.
How did the HSIB secondment come about?
I provided some advice on critical care transfers and the involvement of ambulance services for one of the branch’s early national investigations and I became very interested in its work.
I was encouraged to keep my eyes open for opportunities, and a few months later, I saw a job advert for national investigators. My two years at HSIB gave me really rich insights into how healthcare works and sometimes fails.
What 3 factors make you skip into work?
Learning something new every day.
Making a difference to patient care – in my leadership role this is about making the workplace and systems better for staff, and on my clinical days, it’s about the care I provide to individual patients.
I have autonomy and accountability, which I find empowering and energising.
What’s the best advice you’ve ever got from a patient or work colleague?
When I was a porter, a very seasoned senior colleague told me to remember that it may be the hundredth time I had collected a patient for theatre, but it would be their first time so to remember to take the time to explain to them what was happening and to provide reassurance. This has stuck with me for over 30 years.
If there was one thing you could change about your role or the physical or policy environment you work in, what would it be and why?
I wish that we could focus more on quality and less on targets as I see resources wasted trying to hit arbitrary targets.
What technological advance would have the greatest impact in your field?
Artificial intelligence (AI) will hopefully be a game-changer across healthcare. There are so many applications for AI that will support service planning and delivery of care. Other industries have already embraced AI and improved many aspects of their business.
What do you hope will be your legacy to your profession and colleagues?
I was privileged to have represented my profession on the project team for paramedic independent prescribing, which saw the change in the law in 2018 to allow paramedics to train as independent and supplementary prescribers.
While not planning on retiring just yet, I hope that in years to come I can look back at the changes we made and feel satisfied at how that helped provide better care and raise the profile of the paramedic profession.
Do you have any regrets about your career path?
Absolutely none. It hasn’t been a conventional career at times, and I didn’t get a degree until I was 40, but I would not change a thing.
Do you have to work in dangerous environments?
Healthcare professionals of all disciplines are exposed to events that can have enduring consequences to their physical and mental health, some of which are derived from a single, “dangerous” event, but most are accumulated from a career of exposure to traumatic situations.
One of the privileges of being a paramedic is being present at patients’ most significant life events, including events where their lives end in dangerous situations.
What do you do to relax/de-stress?
Aside from the usual family-related activities, which I absolutely relish, playing the drums is my go-to relaxation method. I also enjoy watching motorsport (and occasionally attend as a paramedic as part of the trackside medical team), running/obstacle course racing, reading, cooking, and holidays.
Which historical character are you most like and why?
Those who end up as noteworthy in history do so through merit or notoriety, and so I cannot compare my very ordinary character traits to anyone of merit, or note. If I had to pick one, he would be fictional – Baldrick from Blackadder because he always had a cunning plan!
Who has been your biggest inspiration?
On the increasingly rare occasions that I get to work in an ambulance, it’s the person sitting next to me in the cab who does the job every day and who drives me, as a leader, to improve their working conditions.
Where are you happiest and why?
Usually behind a drum kit. You are absorbed in the moment when playing, and the only worry is making sure you get the next fill right and don’t lose time.
Andy Collen joined the West Sussex Ambulance Service in 1994 as a patient transport and ambulance technician and trained on the job to become a paramedic, qualifying in 2000. He moved to South East Coast Ambulance Service NHS Foundation in 2005.
After receiving his Diploma in Healthcare Practice (paramedic practitioner) from St George's University of London in 2007, Andy took on an additional, part time role providing urgent care and treating minor injuries at a Surrey Primary Care Trust walk-in-centre until 2009. He stopped when he was made head of programmes and planning/clinical development manager at South East Coast Ambulance Service NHS Foundation Trust.
He was awarded an MSc Professional Practice (Advanced Paramedic) from the University of Surrey in 2013 and, two years later, he was appointed as a consultant paramedic (urgent and emergency care) at South East Coast Ambulance Service NHS Foundation Trust. Here his responsibilities included being the lead for clinical development in urgent care and head of professional standards. He took a two-year secondment to the Healthcare Safety Investigation Branch as a national investigator between 2018 and 2020.
Andy has been medicines and prescribing project lead at the College of Paramedics since 2010 and worked with NHS England to establish and shape independent prescribing for paramedics. He qualified as a non-medical prescriber himself in 2023 and has also been working one day a week part-time as a paramedic practitioner again since 2021, this time at a general practice in Haywards Heath in West Sussex, providing urgent telephone and face to face care.