Transcript 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...

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
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
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
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
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
Title update...

Practitioner in Emergency Care

Emergency Care Practitioner

Physician Assistant

Intermediate Care Practitioner

Community Paramedic
 Paramedic Practitioner
Proposed Education Framework
Level of Award
(All proposed awards are shown)
Title
Role
EMT
Current
 Cert. H.E.
 Dip. H.E.
Paramedic
Current




Paramedic
Practitioner
Category ‘C’ calls
GP Support
A&E Support
Critical Care
Dip. H.E.
Foundation Degree
B.Sc.
B.Sc.(Hons)
 B.Sc. (Hons) & PG
modules
 Postgraduate Dip
 M.Sc.
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...
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
Cross-boundary working...

Innovative role

Taking on some doctors’ work

Autonomous, advanced clinical practice

Guidelines not protocols
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
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
Practice component...
Clinical Placement
A&E
Primary Care
Obstetrics & Neonatal Unit
Paediatrics
Mental Health
Cardiology
Anaesthetics
Duration
13 weeks
15 weeks
1 week
4 weeks
1 week
2 weeks
8 weeks
Looking to the Future...
 Practitioner-lecturers
 Clinical
mentors
 Recruitment
& retention
In summary...
Evolution of original concept
 Consensual approach to new
developments
 Develop a practitioner fit for practice
