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Emergency medicine

Ensuring an emergency care workforce with the right numbers, skills and behaviours is a strategic priority for Health Education England. We are working in partnership with the College of Emergency Medicine and other stakeholders to increase the number of trainees, consultants and multi-professional staff in emergency departments.

Increasing the number of trainees

HEE has established the Emergency Medicine Workforce Implementation Group (EMWIG) to take forward the recommendations made by the former Emergency Medicine Taskforce, published in 2012, and to look at how best to encourage more people into EM as a career. EMWIG is jointly chaired by HEE and the College of Emergency Medicine (CEM) and consists of experts in emergency care and medical education and training. In December 2013, we published a report setting out a wide ranging programme around the new and existing workforce, including ensuring the availability of more doctors in emergency medicine, both in terms of appropriately qualified middle grade doctors and additional trainees for the future.

This work includes expanding the emergency medicine (EM) branch of the Acute Care Common Stem programme (ACCS), establishing a run through pilot for specialty training and developing a mechanism whereby doctors working in other clinical areas can transfer into EM with their skills recognised and progress quickly through the early years of EM training. These actions are having a positive impact on the system and we are currently achieving a 98% fill rate in speciality training meaning fewer vacancies and more doctors.

A more flexible workforce

HEE has been working to support the development of other roles to support patient care in emergency departments, such as by committing to increasing the numbers of physician associates (PAs) in EM, general practice and other areas. As the NHS will continue to recruit more doctors, the role of PAs will be to supplement this expansion, supporting doctors so they can concentrate their time on patients who really need them. We will work with higher education institutions towards the expansion of PA programmes across England and with the Royal College of Physicians (RCP) towards the establishment of the Faculty of Physician Associates to support the profession in the future.

Our local offices have been encouraged to generate and support local strategies to address demand. For example, in the West Midlands we have initiated a number of pilots to increase the skills of pharmacists and the support they provide within the emergency department. We are planning to publish our findings in a report in early 2016.

The Emergency Care Advanced Clinical Practitioner Curriculum

The Royal College of Emergency Medicine (RCEM) and Health Education England (HEE) have co-produced the Emergency Care Advanced Clinical Practitioner (ACP) Curriculum, endorsed by the Royal College of Nursing (RCN).

Higher Education Institutions provide high quality Masters level courses in advanced practice however these do not include specialty specific competences or nationally defined curricula. There is variation in the range of competences acquired, and no standardisation of the level of competence of the practitioner. The ACP curriculum provides an opportunity for standardisation and consistency.

Further details including the curriculum, application form and frequently asked questions can be found on The Royal College of Emergency Medicine website.

Urgent and Emergency Care Review

The Urgent and Emergency Care Review is being led by Keith Willett, National Director for Acute Episodes of Care, NHS England, on behalf of Sir Bruce Keogh, National Medical Director, NHS England. EMWIG is also working in partnership with NHS England and the group will offer expert advice on workforce into the review. More detail can be found on the NHS England website.

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