Thanks all for your input. I've been operational in the ambulance service for 11 years, prior to that I was a talented barman in the student union.
Project management seems to be the right sort of role for me, in that it pays the right sort of level (NHS band 6+) and appeals to my interest in improving and making changes on a wider scale. I enjoy patient contact, but increasingly it has become routine and whilst there are many positives to my role and benefits of shift work, it does not fit well with family life at the moment and the longer I leave it, the greater the pay drop if I do change roles.
Given my Paramedic qulaification pretty much guaranteeing me work when i need it, project based work with a fixed(ish) deadline would be good in that I can chop and change every few years as well, keeping my foot in with ambulance work, whilst moving forward into other directions.
How much would a management qualification be beneficial as well? PRINCE 2 seems to be, "pay the money, do the work, put it on your CV" and use it as a key to get jobs, would other qulaifications be useful or a waste of money if not specifically required?
Also, as I'm in the mood for asking speculative questions, does anyone else have any ideas for jobs that pay £30k, are monday to friday 9-5 ish and don't require a degree?