Marie Antoinette takes over NHS emergency care

Secretary of State for Health

I am grateful to Gav and his Department of Health feed site for drawing my attention to another can of worms that is being opened by the government.

A new species of “Health Care Practitioner” (HCP) (Crippen’s Dictionary of Medical Terms. HCP = “There is no doctor available”) is about to be foisted upon the unsuspecting general public.

Welcome to the “Emergency Care Practitioner”. (ECP)

The Department of Health says here that they are currently consulting about the role of the ECP.

Let us take a quick look at:

Competence and Curriculum Framework for the Emergency Care Practitioner Consultation Document

The government has found that it is far to expensive to pay doctors to look after people with acute medical problems, and so they are going to develop a team of people who are not clever enough to be doctors, but are able to read a protocol, and therefore will be able to function, after a fashion, on the front line of health care. The full training document is here.

Dr Crippen loves this document. It is a joy to see how the English language can be so elegantly strangled to disguise the fact that this is the greatest cut back in emergency medical services in the history of the NHS. It is full of lies and half-truths and, as always with New Labour, oozes jargon.

Let us enjoy some examples. Look for the jargon words like “pathway” and “journey”.


The ECP Mission Statement

A flexible workforce and a flexible approach to skill mix – breaking down professional and traditional boundaries - are central to improving emergency care. This ensures patients receive the highest standard of care, by an appropriately trained person, at an appropriate time, in the most appropriate setting.

The main focus of the role is to enhance the patients’ experience through their emergency, urgent and unscheduled care journey by providing emergency assessment, diagnosis,treatment and aftercare.

(Dr Crippen loves this. "Enhancing the patient’s experience…through their journey." Yum, yum)

Patients can be referred to an ECP by GP’s both in and out of hours, NHS direct, nursing and residential homes, community health teams, i.e. any health and social care worker, either directly or indirectly via the 999 system, the police, the prison service, schools and work places, etc. They treat patients who are unable to leave their home due to poor mobility, have dependants who are unable to be left, and where the outcome would potentially be of greater benefit from an ECP intervention rather than attending A&E or a GP service.

(Sounds plausible, does it not? What it means is that ambulances do not take patients to hospital any more. The ambulance driver will treat the patient himself, even if a doctor has asked for an admission. This is dangerous. Dr Crippen has had a patient killed by this sort of dumbing down - see here)


The Emergency Care Practitioner will:

• Work across current and future organisational and professional boundaries. (pretend he is a doctor, mismanage the patients because he does not know what he does not know)
  
  
• Deliver care that is patient focused. (As opposed to what? Meaningless jargon)
  
  
• Deliver the most appropriate care in the most appropriate place and/or ensure that the patient is referred to the most appropriate health and social care professional. (Often overriding the opinion of the doctor who called the ambulance in the first place)
  
  
• Deliver care to patients in the most convenient and appropriate place for the patient. (refuse to take the patient to hospital)
  
  
• Provide an alternative pathway for the provision of unscheduled care (refuse to take the patient to hospital)
  
  
• Provide appropriate healthcare advice to both their patients and other relevant groups and individuals. (Ignore advice from the doctor and then refuse to take the patient to hospital)
  
  
• Empower patients to take responsibility for managing their own care and treatment where safe and appropriate to do so. (Tell the patient that they have wasted precious NHS resources by calling for help and they should look after their own medical problems)
  
  
• Undertake physical examinations based on a whole systems approach, taking a full and appropriate patient history using a medical model. (Sounds good. But think about it. What does it mean? What “model” other than “medical” would you use?)
  
  
• Treat minor illness and injury in pre-hospital, primary care and acute settings. (refuse to take the patient to hospital)
  
  
• Order appropriate investigations including X-rays and pathological Investigations. (If only they had the competence so to do)
  
  
• Ensure fewer hand-offs between health care professionals and enhance inter-professional communication throughout the patient pathway. (It’s a "pathway", so that is OK, but what does it mean?)
  
  
• Administer and supply medication in line with local Patient Group Directions, (whilst awaiting independent prescribing legislation). (Give out drugs they do not understand)
  
  
• Have the knowledge and skills to access acute hospital beds in specialist units, whenever the patient needs emergency admission as an in-patient. (How do you assess a bed?)

++++++++++

These ECPs will take over the ambulance service and A & E departments throughout the country. There will be no doctors on the front line.

And consider this. If Elizabeth or Phillip, Charles or Camilla, Harry or Wills, or even Tony or Cherie have an acute medical problem, do you think they will see an ECP?

Forget it. The great and the good, the rich and those with private health insurance, will continue to see some of the few remaining doctors.

As always, the dumbing down of heath care, like comprehensive education, is only for the poor folk. They can eat cake.


(any comments under the related article below please)