Yeah, pretty much spot on with the ECA.
Techs, though a dying breed, can insert LMAs, give IM narcan, IM epi, N20, ASA, GTN, hook up and transmit 12-leads etc as well as the other BLS stuff common with the basic EMT.
There is no medical control in the UK...at all...ever, so all decisions are at the discretion of the individual provider (in association with JRCALC guidelines). It is not uncommon to leave many patients at home or advise them to make their own way to hospital (I am sure we all know the type of calls I am talking about). At paramedic level and above, utilizing alternative clinical pathways are commonplace. ECPs can perform minor procedures in the home, such as wound irrigation and suturing, Foley changes, urinalysis and opthalmology - including writing their own prescriptions for ABx where applicable. They can also order diagnostic tests like x-rays etc, without the need for the patient to be seen by a doctor in the ED. Direct referrals to social services or psych facilities also skip the ED.
The system is not without its faults, but clinical autonomy, alternative care pathways, education, and scope of practice take on a whole new meaning when the idea is not to send as many people to the ED, as is humanly possible.
