Emergency Care Practitioners, Case for investment

Submitted by Hugo_Minney on Thu, 09/18/2008 - 20:56

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ECP from Bournemouth who saved two lives in one dayA national programme had the ambitious intent to reduce A&E attendance by 1 million. They had already identified Emergency Care Practitioners (ECP), which is an experienced paramedic/nurse/AHP who receives additional training so that they can diagnose, treat, or refer directly to an appropriate service avoiding A&E.

ECPs are expensive to train (£40,000 each) so the program needed to identify who makes the saving, and how do they know that they've made it. The evaluation and economic modelling, involving extensive stakeholder engagement, showed an ROI of 2 to 3 years through: a single responder in a car instead of two crew in an ambulance to appropriate calls (Ambulance Review 2005: Taking Healthcare To The Patient); reduced A&E attendance (offset against the increased cost of use of other services); and use of additional skills of the ECP in other environments eg Out of Hours. PCTs were able to benefit from the money saved, so PCTs agreed to fund 800 places for training with ambulance trusts (£32 million).

Other outcomes: –

  • a cultural shift towards measuring outcomes (for patients, for the service) not just activity
  • working with the rest of health economy
  • career progression for ambulance men whose previous choices were management or training
  • patients treated at home instead of "scoop and run"

 

Benefits Management - how to deliver ECPs

ECPs are an excellent example of a really successful new form of advanced front-line clinician. They were developed from the ground up, harmonised across the country by sharing benefits and picking the best from each site. I was initially involved with the 17 pilot sites the national team encouraged local innovation, my work was twofold:

  1. to coach the sites so that they reported what they had achieved, and just as importantly the lessons learnt, so that others could steal with pride and converge on a single model
  2. to justify investment by PCTs and Ambulance Trusts in 800 of these advanced practitioners.

ECPs continue to remain a distinct and homogeneous new profession, one of very few widely adopted new professionals in 15 years, and I continue to serve on the national panel steering the profession to registration.

Some of the key publications to emerge are listed in the child pages to this page (below)

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Recent Additions and Updates

If I were running the country - encouraging business

Submitted by Hugo_Minney on Tue, 05/21/2013 - 09:33

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Minimum wage

Fantasy government - what would I do if I were in government?  Well how about reduce corporation tax, increase income tax, increase minimum wage and invest in job creation in the regions?  That would be a good start - create jobs where there are workers, then make sure that the right amount of tax is collected and at the same time reduce spend on benefits which are only used to increase profits of selfish organisations.

Would it work?  Have your say.

PwC Report on the Current State of Project Management

Submitted by Hugo_Minney on Fri, 05/17/2013 - 10:44

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PwC Project Management ReportPwC found that successful companies are getting more mature in their project management ability.  This raises the game – successful companies have lower costs from fewer failed projects, and less successful companies have to work harder to catch up.  There are some important lessons to take this report for everyone – Read more…

Joy instead of tedium

Submitted by Hugo_Minney on Fri, 05/10/2013 - 21:04

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The Office

Every office has them - the tasks that have to be done that nobody likes doing.  Whether it's the audit, the wages, standard letters, whatever it is - someone has to do it and it feels like a waste of time and money.

Why should you care?

So you employ somebody, so why do you care about how tedious the task is? Well they are costing money, to do something that could be done far more effectively.

Learning from the Past

Submitted by HugoM on Fri, 05/10/2013 - 20:27

Evidence for service improvement

Many public service changes have little basis in evidence. Their success (or otherwise) does not appear to depend on how 'good' the policy itself is, but rather on how it has been implemented. This relies on staff attitudes and relationships. My research falls into a number of broad categories: finding out what is currently happening; what people think about it; and what people think it will mean.

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Consumer Price Index (CPI) Calculator for SROI

Submitted by Hugo_Minney on Tue, 04/16/2013 - 10:05

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CPI components

When calculating a Social Return on Investment (SROI) evaluation or SROI forecast , sometimes you have to rely on published figures from reports.  But if these are from a few years ago, then they probably need adjusting for inflation.

There are calculators on the web to do this for you, but I found them cumbersome and it was difficult to keep a record of what calculator I'd used, and how, for which value - auditability and transparency is vital for SROI.  So here's a spreadsheet to do this properly!