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13.10.17

Root causes of ED staffing crisis must be addressed, says BMA

The BMA has warned that NHS England’s plan to ease winter pressures will not be enough.

As part of the winter contingency plan developed by NHS Improvement, NHS England, Health Education England and the Royal College of Emergency Medicine, NHS England has announced plans to increase the number of emergency medicine trainees next year from 300 to 400.

It says it will provide further development for emergency medicine trainees, target support to improve the clinical education environment in struggling trusts, and invest in developing the role of the advanced clinical practitioners in emergency departments.

The plan includes the recruitment of 300 people onto acute care common stem-emergency medicine each year for four years, an additional 100 doctors per year for four years into training programmes to develop emergency medicine skills, and increasing physician associates (PA) from the current 350 to 3,200 in 2019.

Dr. Chaand Nagpaul, BMA council chair, welcomed any steps to address the recruitment crisis faced by emergency medicine, but warned: “With many existing training places going unfilled we need to address the root causes of the staffing crisis in our A&Es, in particular concerns around workload, stress and burnout.”

He also argued that PAs must not undermine the roles of junior doctors. “Physician associates are a valued part of the NHS but it’s important to be clear about the scope of their work, which is to provide an intermediate level of care and help reduce workload pressures,” he explained.

“Only doctors can provide certain types of care so the government need to ensure that standards won’t be affected by these changes and the quality of patient care will be protected and maintained.”

He stressed that general practice and social care also face rising pressures during winter, and that any panel should adopt a system-wide approach.

“What the NHS really needs is additional capacity, more beds, staff and funding to deal with the rise in demand on services which becomes acute during the winter period,” he concluded.

Dr. Tag Hassan, president of the Royal College of Emergency Medicine, was more optimistic about the plans: “We are delighted to be launching this visions for emergency medicine which sets out to tackle the workforce challenges facing the service.

“The additional resources are much needed and there are a large number of initiatives here which together will mean that emergency medicine can rebuild.”

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