Today’s question comes from a paramedic who says:

I was directed to you to assist me in answering a question about who should be responsible for the maintenance of skill competency. Specifically: intubation. As the scope of practice includes Intubation is it each clinician’s duty to maintain competency in this skill, or being a high risk low frequency skill is it the employers responsibility to ensure clinicians are performing competently by introducing skill competency assessment or minimum performance logs? Or does responsibility fall to a combination of both employer and employee?

The answer is ‘responsibility fall[s] to a combination of both employer and employee’.  If a paramedic thinks he or she is not proficient in the skill then he or she has an obligation to look for CPD opportunities to maintain that skill or raise it with their employer if it is a systemic issue.

The employer is sending people out representing it and given it’s ‘a high-risk low frequency skill’ the employer has a responsibility to ensure that it is done correctly. IN the health care setting the employer has a non-delegable duty of care, that is it has a duty of care to its patient’s, and it cannot meet that duty by simply saying ‘but I employed registered health professionals to do the job’. An employer also has obligations to ensure that the care provided meets the standard of reasonable care.

How the balance is managed is a matter for negotiation.