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The right staff in the right places

  • Last modified date:
    20 August 2007

A major part of reducing waiting times in A&E and improving the patient's overall experience is to ensure that they are seen at the right time, in the right place and by staff with the most appropriate skills.

This is good clinical practice and it will be crucial to achieving the overall target for A&E waits:

Key target

  • By the end of 2004 patients will wait no more than four hours in A&E from arrival to admission, transfer or discharge.

Work in progress

Recruiting more staff is obviously vital to reducing waits and improving services right across the NHS. An important part of the work in this area will involve using data about emergency care staffing and skills to influence the wider reforms. This will help to define the numbers and types of staff needed, as well as where they are needed, to deliver The NHS Plan targets.

But equally important will be developing a clear picture of the skills and training emergency care staff need to deliver flexible, responsive and patient-centred services. Specifically, this involves:

  • Defining the care required to deliver the Reforming Emergency Care plan.
  • Defining the competencies and skills needed to deliver this care.
  • Exploring new roles, and new ways of working.

As part of the work to identify and improve the different skill mixes and competencies within the emergency care system, The Modernisation Agency's changing workforce programme is piloting the new role of emergency care practitioner (ECP). The pilot is looking at an expanding role for paramedics and emergency care nurses working in A&E, pre-hospital areas such as minor injury units and walk-in centres, primary care as well as in more traditional ambulance settings.

Future thinking

One focus will be on developing a competency framework that can be used at national and local level to support recruitment and retention policies as well as identify skills gaps in the emergency care workforce. It will be crucial to develop and test this framework in partnership with the key professional bodies.

Work will also include sharing emergency care good clinical practice and tackling inappropriate barriers, whether professional or organisational, which are hindering the delivery of accessible emergency care.

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