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17.11.15

New clinical roles will revolutionise urgent care

The NHS urgent and emergency care (UEC) workforce is under scrutiny by Health Education England (HEE) to assess whether it is fit for purpose and offers a sufficient supply of staff to meet future demands, Sir Bruce Keogh, NHS England’s medical director, has confirmed.

Part of this includes describing and ensuring the supply of a trained alternative workforce out of hospital and on the interface with emergency departments to support the UEC agenda.

For example, NHS England is looking to develop and promote roles such as physician associates, paramedics, pharmacists and advanced clinical practitioners that can help with the changing scenario.

Concerning paramedics, Keogh has stated that a new single accredited curriculum is in development, which academic institutions will begin to deliver from 2016.

The curriculum is expected to “markedly enhance” paramedic skills to ‘hear and treat’ and ‘see and treat’, as well as work independently and in wider urgent care, such as primary care, as an alternative to A&E and ambulance services.

These changes all fall under the recent NHS England drive to integrate services through waves of speciality Vanguards. Eight UEC Vanguards were announced in July, tasked with transforming emergency care services by bringing together A&E, GP, pharmacists and the NHS 111 telephone service.

HEE is also collaborating with NHS England, the RCGP and the BMA on the 10-point plan for primary care, which Keogh says is “equally important in increasing the workforce capacity of not just general practice, but the wider primary and community care workforce, and the implications of this in supporting the urgent care agenda”.

From today, this will also be supported by 408 clinical pharmacists working from GP surgeries as part of a £31m push to ease GP workload and provide direct patient care.

If delivered successfully, these changes will ensure that, by 2020, the NHS offers a networked approach to delivering urgent care, led by local commissioners and providers.

This would include a single number (NHS 111) for all urgent health needs, wide access to clinicians and health records regardless of location, faster service booking and home-based care.

Other information on specific deadlines for each component of the UEC transformation can be found in NHS England’s board papers ahead of its meeting on Friday.

(Top image c. Peter Byrne)

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