1. Paramedic evidence-based education project (PEEP)
November 2014
Paramedic evidence-based education project (PEEP)
Patrick Mitchell
Director of National Programmes
Health Education England

2. Background
Commissioned by DH’s National Allied Health Professional Advisory Board - funded by the College of Paramedics, reporting in August 2013
Provides an evidence base to progress the strategic direction of the standardisation of education and training
Various education and funding models in place across the UK - PEEP seeks to address these issues
Delivery lies with Health Education England (HEE), the College of Paramedics and the Association of Ambulance Service Chief Executives

3. PEEP Report Passed over to HEE in July 2013
HEE asked College of Paramedics to co-chair an oversight national steering committee
Devolved nations invited to be active participants to deliver UK solution
The paramedic profession is the only AHP:
With no single education level entry route to registration with HCPC
No clearly defined or aligned career structure leaving inconsistency in titles, scope of practice and purpose
Advanced prescribing necessitates both to be agreed and in place before the non-medical prescribing board will consider a business case from the profession

4. Recommendations from PEEP
There should be a nationally agreed approach to the commissioning and funding of paramedic education with access to bursary funding
Models of pre-registration education and training should align with other non medical professions and lead to an all graduate profession
There should be a review of the College of Paramedics scope of practice and HCPC standards of proficiency
Evaluate education and development opportunities for the existing workforce and embed a whole systems approach to enhance the learning environment for the student paramedic
There should be an enhancement of clinical skills and clinical decision making developed through the College of Paramedics curricula

5. Clinical Skill Enhancement
There should be additions to the clinical skills in pre-registration training in the areas of:
Dementia and mental health awareness
Clinical leadership skills
Multi-professional learning opportunities
Integrated care
End of life care
Inclusion health
There should be a closer engagement of this workforce with pre-hospital urgent care, and prevention of hospital admission, should be of benefit to the wider community.

6. PEEP report and recommendations
There are two critical interdependencies to the engagement programme:
Consultation on paramedic prescribing
Intention to commence public consultation on paramedic prescribing by the end of the calendar year
To be delivered in advance or alongside PEEP strategy consultation in order to ensure stakeholders can present an informed view
The outcomes of Keogh’s urgent and emergency care review
PEEP is a major contributor to the success of both hear and treat & see and treat strategies
New paramedics roles in ED and primary care settings
Will require a significant increase in training capacity at scale

7. Delivering PEEP – project structure
Education & Training Steering Group
Ways of working /scope of practice
PEEP Report Recommendation
Sub Group Leading
Education models
Clinical models
Urgent Care Steering Group
Workforce planning
1.0 Standardised approach to education and training
Scope of practice and ways of working
1. Nationally agreed approach to commissioning and funding
Finance
1.2 Access to bursary funding
Finance Commission-ing
2.0 Pre-registration education development model leading to an all graduate profession
3.0 Models of pre-registration education and training
Clinical
standards
3.1 Knowledge and skills enhancement
Comms & engagement
3.2 Content
3.3 Clinical decision making
4.0 Partnership model
5.0 Paramedic leadership for England
6.0 Standardised approach to identification
Communications

8. Ways of working & Scope of practice sub group
There should be a standardised approach to all aspects of education and training for paramedics
Paramedic registration should be at BSc level by 2019/20
Supports amendments to the scope of practice and curricula developed by the College of Paramedics
Supports a national model of commissioning and funding for pre-registration paramedic education (model still to be determined)
Pre-registration paramedic education should be included in the new National Standard Education Framework Agreement
Agrees Standards of proficiency and standards of education and training together with the College of Paramedics curricula guidance and competency framework will be submitted for independent educational levelling to confirm the standards of education at BSc level.

9. Current position
The steering group have recommended further work be undertaken before being presented to HEE Board for approval
Steering group with two new groups recently formed to review:
Educational modelling to develop options programme delivery and educational funding
Paramedic employers group supported by NHS Employers to assess employment implications of the changes of the paramedic role including union consultation
Workforce planning and modelling of options based on training commissions required to meet urgent and emergency care review and other needs of new models of care.

10. Transition recommendations
The steering group has supported:
That education and development opportunities for the existing workforce should be considered and a transition plan formed
That organisations should have mentoring and preceptorship arrangements in place consistent with the curricula requirements
That an engagement programme needs to be delivered from a national platform to have the necessary influence, supported by local delivery plans
Specific consideration in transition planning should be given to:
The current paramedic workforce
Impact on skill-mix
The current technician workforce
Impact on employee relations
Impact on terms and conditions
Staff engagement

11. Education Development
Managing Transition
Current Technician Workforce Current Paramedic Workforce
Terms and Conditions Skill Mix Employee Relations Engagement
Education Development
Employment Issues
Workforce Planning

12. Next Steps Complete educational levelling
Financial viability to be fully assessed
Assessment of workforce numbers - options
Requirements and transition planning for up-skilling the current workforce
Communications strategy to be developed
Employers group to assess job design and alignment within current agenda for change framework
NHS commissioner engagement
Union consultation
Discussion with HCPC
Development of an implementation plan

13. Next Steps
Further discussions with key stakeholders including employers, commissioners and unions
HEE Board approval March 2015
Final sign off nationally with employers and commissioners
Formal notice to higher education institutions
Finalise timeline with HCPC

14. Questions?