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PECs: from concept to reality

PECs: from concept to reality. Nikki Williams Malcolm Woollard. Drivers for change. Meeting challenging performance standards Rising number of 999 calls Workload of A&E departments Challenges facing primary care Clinical governance. The need for higher education.

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PECs: from concept to reality

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  1. PECs: from concept to reality Nikki Williams Malcolm Woollard

  2. Drivers for change... • Meeting challenging performance standards • Rising number of 999 calls • Workload of A&E departments • Challenges facing primary care • Clinical governance

  3. The need for higher education... • Current paramedic training focuses on life-threatening conditions • provides limited under-pinning knowledge • is protocol driven • All other professions within the HPC mandate graduate entry

  4. JRCALC/ASA - PEC concept... • Generic Emergency Practitioner • advanced knowledge / skills • critical care • triage • treatment of minor conditions • 3-year Full-time Degree plus probationary year • rotation between different health care settings

  5. Meanwhile... • A few HEIs offering B.Sc. degrees for paramedics • developed in collaboration with partner ambulance services to meet local needs • full & part-time, pre and post registration • not aimed at advanced clinical practice • no strategic management of developments

  6. Towards consensus... • Higher Education Ambulance Development Group (HEADG) • representatives of universities and ambulance services involved in higher education for ambulance staff • representation sought from JRCALC, BPA, HPC, ASA, AETAG • specialist advisors

  7. HEADG Aims to: • raise standards of education in pre hospital care • provide a framework of higher education for ambulance staff • devise subject benchmarks for degrees • reach consensus on the role, knowledge base and scope of clinical practice for PECs • develop national standards for PECs • undertake collaborative research / evaluation of education programmes

  8. Title update... • Practitioner in Emergency Care • Emergency Care Practitioner • Physician Assistant • Intermediate Care Practitioner • Community Paramedic • Paramedic Practitioner

  9. Proposed Education Framework

  10. Some questions... • How can we improve management of non-emergency 999 patients? • How can the problems with primary care be addressed? • Can available resources be better employed to improve patient care? One possible solution...

  11. Welsh Paramedic Practitioner scheme... • Partnership between Swansea University, the Welsh Ambulance Service, local NHS Trusts and primary care providers. • 2-year pilot study • year one: 2 days per week at university and 3 days per week in clinical placements • year two: spent practising under close supervision of academic and clinical staff, with 1 day per month at university

  12. Cross-boundary working... • Innovative role • Taking on some doctors’ work • Autonomous, advanced clinical practice • Guidelines not protocols

  13. A question of level... Paramedic practitioners will need to: • “... deal with complex issues both systematically and creatively, make sound judgements…” • “...act autonomously in planning and implementing tasks…” • “…practise decision-making in complex and unpredictable situations…” QAA descriptors for M.Sc. level

  14. Educational programme • M.Sc. Advanced Clinical Practice • multi-professional programme • fosters inter-professional communication and understanding • shared core modules • specific modules for paramedic practitioners • focus on developing advanced levels of clinical practice

  15. Practice component... Clinical Placement Duration A & E 13 weeks Primary Care 15 weeks Obstetrics & Neonatal Unit 1 week Paediatrics 4 weeks Mental Health 1 week Cardiology 2 weeks Anaesthetics 8 weeks

  16. Looking to the Future... • Practitioner-lecturers • Clinical mentors • Recruitment & retention

  17. In summary... • Evolution of original concept • Consensual approach to new developments • Develop a practitioner fit for practice

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