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Once you have been working as a registered paramedic for two years, you can progress to roles that allow you to carry out more treatments, specialise in specific areas and take on more responsibility.For the more senior paramedic roles, you first have to work as a paramedic and be registered with the Health and Care Professions Council (HCPC). You then take extra training for one of the roles for experienced paramedics. You may have to take a further qualification, depending on which qualifications you already hold.Most jobs in the NHS are covered by the Agenda for Change (AfC) pay scales and experienced paramedics usually start at band 6. This pay system covers all staff except doctors, dentists and the most senior managers. Although senior paramedics work standard hours of around 37.5 a week, these are often on a shift pattern. Shifts can cover 24 hours a day, 7 days a week throughout the year, so a paramedic’s work pattern may include, evenings, nights, early starts, weekends and bank holidays.Experienced paramedics need to be calm in stressful situations, resilient in dealing with other people’s strong emotions, able to work quickly and carefully, have good communication skills, excellent driving skills and be able to use equipment and machinery.With experience, you could become a team leader, supervising the work of paramedics and emergency care assistants. You could become a manager, responsible for several teams. In some ambulance trusts you could progress to consultant paramedic, advising on and developing the clinical practice in that service. Teaching or research are other options. Some experienced paramedics choose to join a specialist team such as caring for stroke patients or working on an air ambulance.