Health workers' union Unison has pulled out of a national pilot aimed at training ambulance personnel.
It said the Emergency Care Assistant (ECA) scheme had been designed to replace qualifed ambulance workers with a lower grade of staff.
The ECAs would have less medical training and responsibility than either technicians or paramedics.
But Tim Lynch, Great Western Ambulance Service (GWAS) chief executive, said ECAs played a vital emergency role.
Project a 'mockery'
Unison branch chairman Ian Whittern said "under-trained" ECAs placed qualified staff under more pressure and put patients at greater risk.
"We were meant to liaise closely with South West Ambulance to develop this role safely.
"This has never occurred which makes a mockery of this joint project."
Mr Whittern said Unison would be demanding that ECAs be brought up to the standard of training demanded of technicians.
It added that relations between staff and management were worsening and called on the Secretary of State for Health to intervene.
Mr Lynch said ECAs were supporting paramedics and technicians across Avon, Gloucestershire and Wiltshire.
"They assist with treatment and care, whilst ensuring that patients are reached swiftly and are transported to hospital quickly and safely," he said.
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