PECs: from concept to reality

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 AE 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