Specialist Paramedics (ECPs)
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A new deployment model in Milton Keynes targeted specialist paramedic responses to the most appropriate calls. This resulted in 68% of patients seen by specialist paramedics not being conveyed to the emergency department, helping to reduce conveyance rates. Data showed conveyance rates dropped from 50% in Milton Keynes in September to 15% in December after targeted specialist paramedic deployment began in November. Specialist paramedics can positively impact the ambulance service by attending all NHS111 calls, visiting patients to confirm if a double-crewed ambulance is needed, and reflecting clinical commissioning group values of reducing silo working and enhancing patient experience. However, some specialist paramedics feel uncertain about their job security and role within the ambulance service in
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Improving CPR success rate Improvement Project (FOCUS-PDCA)
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This document describes a quality improvement project at Al-Iman General Hospital to reduce variability in cardio-pulmonary resuscitation (CPR) success rates. Data showed failure rates ranging from 60-80% monthly, above the benchmark of below 60% set by the Ministry of Health. A team analyzed causes of variation using a fishbone diagram and identified outdated CPR policies, lack of ACLS training, and lack of defibrillator maintenance as key issues. The team selected remedies including updating CPR policies, establishing maintenance schedules, and providing additional training. A pilot implemented the solutions and saw improved availability of supplies and a reduction in failure rates and missing team members. Ongoing monitoring is planned to sustain gains.CAHPO 2016. Workshop 2: Darran Palmer
This document discusses the history and development of paramedic practitioners and community paramedicine in the UK. It traces the evolution of paramedic training from 2005 to becoming degree-level in 2019. It also outlines key reports and pilots that expanded the paramedic role to provide more care in the community. The community paramedic model aims to improve access, reduce conveyance rates, and shift more treatment out of hospitals. Initial indicators from the Thanet pilot show improved response times and higher staff satisfaction with the new model.
South East of England Mental Health CEO Forum
Despite their impossible schedule & demands, the CEOs of mental health trusts in the South East of England kindly allowed us to discuss the latest access and quality standard.
Transforming Urgent and Emergency Care: Safer, Better, Faster
The document discusses strategies to manage increasing demand on emergency departments (EDs/A&Es) in the UK. It notes that EDs/A&Es have become a strong brand that is difficult to change patient behavior away from. It recommends co-locating primary/urgent care services with EDs using the established ED brand to direct appropriate patients elsewhere. Co-location has advantages like shared resources and ability to transfer patients, while addressing issues of EDs treating non-emergencies.
The Latest Regulations, Simplified: MU, PQRS & MIPS
Changing governmental regulations for the advancement of healthcare is more than difficult and we have simplified these changes to keep you up to date.
Evaluating health and social care interventions in a CCG - Jo Broadbent
This document summarizes two case studies evaluating health and social care interventions in a clinical commissioning group (CCG) in the UK. The first case study found that expanding early supported discharge (ESD) services for stroke patients reduced social care packages by 57% and saved an estimated £172k-£572k per year. The second case study evaluated "virtual wards", which used multidisciplinary case management in the community, and found a 19% reduction in avoidable hospital admissions and increased integration between health and social care services. The document discusses challenges with evaluation including data limitations and managing expectations of decision-makers.
The GP in depth review (2013)
How bad is the GP workforce shortage in England and what should be done about it? The Centre for Workforce Intelligence (CfWI) was commissioned by the Department of Health and Health Education England to conduct an in-depth review of the general practitioner (GP) workforce in England in 2012.
This presentation gives our preliminary assessment - but for those interested, I recommend you read the final report published in July 2014. It can be found here: http://webarchive.nationalarchives.gov.uk/20161007102824/http://www.cfwi.org.uk/publications/in-depth-review-of-the-gp-workforce
Note: The Centre's contract with the Department of Health ended in March 2016. Some of its analysts and functions were brought in-house by DH. The Centre's website is archived here: http://webarchive.nationalarchives.gov.uk/20161007101116/http://www.cfwi.org.uk/
Slides from the 'Improving access to seven day services' event June 2015
This document provides information about an event to improve access to seven day services in the NHS England Greater Manchester & Lancashire region. It includes the agenda for the event, with presentations on topics like the national agenda for seven day services, clinical standards, self-assessment tools, and case studies from organizations implementing seven day services. Wrightington, Wigan & Leigh NHS Foundation Trust will present their experience in delivering seven day services, including how increased consultant presence on weekends and improved diagnostic and support services have reduced weekend mortality rates. Interactive polling will gather input from attendees on challenges and priorities for seven day services implementation.
RCN%20Guidance%20for%20nurse%20staffing%20in%20Critical%20care
This document provides guidance on nurse staffing levels in critical care settings. It discusses several factors that should be considered when determining appropriate staffing, including patient dependency, the role of critical care nurses, staffing levels and skill mix. While patient dependency is important, it is only one factor - other considerations include the patients' safety needs, required observation and intervention, and the knowledge and experience of the nurses. The best approach is for senior critical care nurses to assess the resources required by each patient. Effective workforce planning is essential to ensure patient needs are met.
Health UX - Hamish Dibley - Understanding Patient Demand: a better way to mak...
A new and refreshing approach to understanding and improving healthcare systems. Hamish outlines his alternative approach to realising better healthcare services at less cost. It begins with looking at healthcare not from a conventional activity perspective but from a person-centred one.
Quality, Innovation, Productivity and Prevention in Primary Care
What do the Quality Ambitions mean for Primary Care? This session describes the ongoing innovative local improvements and national work with NHS
Boards and Primary Care contractors to improve quality, efficiency and outcomes as well as the future plans for Primary Care.
South EIP Programme Update 2019-20
Update on regional performance of the South West and South East Early Intervention in Psychosis (EIP) programme including the support offered to NHS England to achieve the nationally set standards.
Bernie Harrison - Australian Council Healthcare Standards
The document discusses using targets to improve healthcare performance and patient safety. It notes that while modern medicine is advanced, healthcare systems still fail to meet their full potential due to issues like clinical practice variation and preventable medical errors. Targets have been implemented, like the 4-hour rule for emergency department wait times, but focusing only on targets can incentivize the wrong behaviors. True reliability and safety require a culture that learns from failures and embraces continuous improvement. High-reliability organizations exemplify principles like preoccupation with failure and deference to expertise. The goal should be zero preventable harm through reliable processes of care.
The Business Case for Quality - Gerry Marr
As the financial and demographic landscape changes, our healthcare services need to provide something significantly different to meet the needs of the Scottish population. In this session Gerry Marr talks about how do we make best use of the resources we have and what are we already doing that is transforming healthcare.
Seven Day Hospital Services Workshop: South East
This workshop event, hosted by NHS England and NHS Improvement, brought together acute trust’s working towards the delivery of the four priority clinical standards by March 2018. Trust clinical leads and operational managers shared local challenges and solutions to delivery.
Quality improvement in reproductive, maternal, newborn and child health
Presentation given at the USAID SQALE Symposium, Bridging the Quality Gap - Strengthening Quality Improvement in Community Health Services, by Prisca Muange on behalf of USAID Assist. http://usaidsqale.reachoutconsortium.org/
Making Sense of MACRA
The healthcare transformation from fee for service to fee for outcomes just got an adrenaline shot in the arm April 27th when the Department of Health and Human Services surprised many in the market by announcing a Quality Payment Program, a proposed set of new rules to take effect in 2019 based on key provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
South EIP Programme Support and Assurance 2018-19
A brief summary of the focus of the work of the South of England Early Intervention in Psychosis (EIP) Programme in 2018-19 as we work across systems, organisations and teams to drive better quality and outcomes for people with early psychosis and their families.
Similar to Specialist Paramedics (ECPs) (20)
How Allina Health Uses Analytics to Transform Care - HAS Session 16
How Allina Health Uses Analytics to Transform Care - HAS Session 16
The alphabet soup of clinical quality measures reporting and reimbursement 2...
The alphabet soup of clinical quality measures reporting and reimbursement 2...
Improving CPR success rate Improvement Project (FOCUS-PDCA)
Improving CPR success rate Improvement Project (FOCUS-PDCA)
Transforming Urgent and Emergency Care: Safer, Better, Faster
Transforming Urgent and Emergency Care: Safer, Better, Faster
The Latest Regulations, Simplified: MU, PQRS & MIPS
The Latest Regulations, Simplified: MU, PQRS & MIPS
Evaluating health and social care interventions in a CCG - Jo Broadbent
Evaluating health and social care interventions in a CCG - Jo Broadbent
Slides from the 'Improving access to seven day services' event June 2015
Slides from the 'Improving access to seven day services' event June 2015
RCN%20Guidance%20for%20nurse%20staffing%20in%20Critical%20care
RCN%20Guidance%20for%20nurse%20staffing%20in%20Critical%20care
Health UX - Hamish Dibley - Understanding Patient Demand: a better way to mak...
Health UX - Hamish Dibley - Understanding Patient Demand: a better way to mak...
Quality, Innovation, Productivity and Prevention in Primary Care
Quality, Innovation, Productivity and Prevention in Primary Care
Bernie Harrison - Australian Council Healthcare Standards
Bernie Harrison - Australian Council Healthcare Standards
Quality improvement in reproductive, maternal, newborn and child health
Quality improvement in reproductive, maternal, newborn and child health
Specialist Paramedics (ECPs)
- 1. Specialist Paramedics (Emergency Care / Paramedic Practitioners)
- 3. Culture System factors Geography National variations in non-conveyance rates due to: National Ambulance Commissioners Group reported SCAS figures were unremarkable
- 4. Milton Keynes Specialist Paramedic Team A new deployment model targeted the most appropriate calls for Specialist Paramedics See & Treat/ Refer 68% Patie nt to A&E 32% SP attendance changed the disposition from crew taking patient to A&E 68% A&E avoidance by Specialist Paramedics
- 5. 0 0.115 0.23 0.345 0.46 0.575 ValueAxis Non-Conveyance Smart deployment works 50 % 45 % 30 % 15 % 0% Milton Keynes Oxfordshire Buckinghamshire Berkshire National September October December Targeted deployment from November November
- 6. Culture System factors Geography National Ambulance Commissioners Group Leadership, demonstrate +ve outcomes Highly mobile Clinical Hubs Specialist Paramedics will impact:
- 7. System factors Culture Geography National Ambulance Commissioners Group Clinical Hubs of Specialist Paramedics
- 8. National Ambulance Commissioners Group College of Paramedics and NHS Career Framework Consultant Paramedics - Level 8 Paramedics - Level 5 Specialist Paramedics - Level 6 Advanced Paramedics - Level 7 Community Services - 1 for each pair of Clinical Hubs - minimum of 6 per Clinical Hub - 3 Trustwide - skilled ‘generalists’ who may choose additional educational modules to specialise in either ‘Urgent’ or ‘Critical’ Care This is level of Practice, not AfC Pay Banding…
- 9. Specialist Paramedics may be prepared to change base station or shift pattern feel the Ambulance Service doesn’t value their work-life-balance Dynamic & flexible 76% 90% 27%
- 10. Specialist Paramedics Dynamic, flexible, & professional want to positively impact on Ambulance Service performance by: - attending all NHS111 calls - visiting certain ‘Health Care Professional Admissions’ to confirm a Double-Crewed Ambulance is appropriate 77%
- 12. Specialist Paramedics reflect CCG values: Reduce ‘silo-working’ Collaborate with Multi-Disciplinary Team Enhance patient experience
- 13. 5,000,000 10,000,000 15,000,000 20,000,000 25,000,000 2004 20131988 2003 Supply-Induced Demand? Main A&E remains stable Total includes MIU and WiC
- 14. Specialist Paramedics Generally content: considering leaving for other Urgent Care providers …worth investing in want to be with the Ambulance Service in 5 years’ tim 22% 61%
- 15. Specialist Paramedics Uncertain job security: believe they will be downgraded to Level 5 Paramedic but hope their role will expand and be enhanced …use them or lose them 27% think the Ambulance Service doesn't know how to use them 18%
- 16. Specialist Paramedics - great job prospects outside the Ambulance Service
- 17. References 1. Woolard M. (2006). The Role of the Paramedic Practitioner in the UK. Australasian Journal of Paramedic Practice 2. Health and Care Professions Council (2013) 3. Electonic survey distributed to SCAS ECPs through internal email during January 2014 (total responses n=23) 4. The King’s Fund (2013). Are accident and emergency attendances increasing? http://www.kingsfund.org.uk/blog/2013/04/are-accident-and-emergency-attendances-increasing