The National Institute for Health and Care Excellence is recommending that the NHS provide more advanced paramedic practitioners (APPs) to help alleviate pressure on emergency departments.
In new draft guidelines, the cost watchdog says it has reviewed evidence showing that use of APPs can slash hospital admissions by 13 percent compared with standard paramedics.
APPs have powers to treat patients in the community, refer them to a GP or decide if they should go to hospital. They are also allowed to administer stronger pain relief compared than standard paramedics and can decide if a wound requires stitches.
Highlighting their money-saving potential, the Institute noted that one study previously published in the British Medical Journal study suggests that for each APP the NHS can save up to £72,000 a year.
“It is essential we spend what money we have wisely, investing in areas where we’ll see a real improvement in care for everyone,” noted Professor Julian Bion, consultant in intensive care medicine at Queen Elizabeth Hospital and chair of the NICE guideline committee.
“Increasing the number of advanced paramedics we have working across the country is one way we can achieve this. Their skills and expertise can help to ease pressure on emergency departments and ensure patients are cared for in the most appropriate location.”
The guidance also makes wider recommendations about emergency and acute medical services to standardise care across the NHS.
In line with plans for emergency care laid out in NHS England’s Five Year Forward View, it supports providing nurse-led support within the community for people who are at risk of hospital admission, daily consultant reviews of patients admitted to hospital with a medical emergency including weekends and bank holidays, and automatic, seven-day access to physiotherapy and occupational therapy where needed.
The document also makes a series of recommendations for research, including exploring whether extended access to GP services and social services is more clinically and cost effective than standard access, the clinical and cost effectiveness of having GPs within or adjoining emergency departments, and different methods for integrating patient information throughout the emergency medical care pathway.