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• Author's Reply: Emerging role comparisons
  Simon J Cooper
  Published on: 19 October 2005
• There is a lack of other professionals for ECPs to be compared with
  Mark J Bilby
  Published on: 26 April 2005
• Emergency Care Practitioners should not be compared with paramedics
  Suzanne Mason
  Published on: 4 January 2005

• Published on: 19 October 2005

  Author's Reply: Emerging role comparisons

  • Simon J Cooper, Principal Lecturer

  Dear Editor,

  As the lead author of this paper I was glad to read the letters of Mason and Bilby who clearly add to the debate of how we should evaluated new and emerging roles.

  To clarify our approach it must be understood that we were collecting data for this study in 2002, examining the role of four of the first ECPs in the country. We were asking the question 'if you change individuals roles (through tr...

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  Dear Editor,

  As the lead author of this paper I was glad to read the letters of Mason and Bilby who clearly add to the debate of how we should evaluated new and emerging roles.

  To clarify our approach it must be understood that we were collecting data for this study in 2002, examining the role of four of the first ECPs in the country. We were asking the question 'if you change individuals roles (through training and the system of call out) what difference does it make to their practice'?

  We took a multi-methods approach in that we used interpretist approaches (interviews and relective diaries)and a positivist stance in our comparison of ECP and paramedic roles. This was intended as a comparsion, the paramedics were not intend as a 'control' in any way.

  We chose to compare roles, as at the time (2002) the 'crew room chat' was all about this new role with some holding the view that ECPs do little more than a good paramedic. In addition, as we mention in the discussion section of this paper, we may also have found that there was no difference, for example, in conveyance rates (paramedics v ECPs) which would have raised questions about the investment in the role.

  The scene (2005) has now changed and ECPs do appear to be developing distinct and unique roles, so a comparsion with paramedics would indeed now be less relevant. In fact, in some current work we are now focussing on ECPs role in inter-professional collaboration, which in our provisional findings appear to be diverse, with many potential benefits for the patient.

  Simon Cooper

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  Conflict of Interest:
  None declared.

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• Published on: 26 April 2005

  There is a lack of other professionals for ECPs to be compared with

  • Mark J Bilby, ECP

  Dear Editor,

  I too enjoyed the paper, "The emerging role of the emergency care practitioner" submitted by S.Cooper et al. I was gratified to see that Suzanne Mason had read the paper and replied.

  My thoughts on the suitability of the paramedic and ECP comparison, however, differ from Dr Mason's. Whilst I accept the comments in her letter with particular reference to the training and education of par...

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  Dear Editor,

  I too enjoyed the paper, "The emerging role of the emergency care practitioner" submitted by S.Cooper et al. I was gratified to see that Suzanne Mason had read the paper and replied.

  My thoughts on the suitability of the paramedic and ECP comparison, however, differ from Dr Mason's. Whilst I accept the comments in her letter with particular reference to the training and education of paramedics and thus their ability to carry out a similar role, I have to ask the question, who should we be compared with for the purposes of this type of paper?

  The role of the ECP is so relatively new and in real terms one that occupies a unique position within the NHS that comparison with any individual group may well be inappropriate. However the starting point of paramedics is a valid one, not least in terms of the patients seen within the study.

  With the forthcoming completion of the SCHARR national study on ECP's I look forward to seeing some further research and evidence on a broader basis. Which will help with future developments of the ECP role across the country.

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  Conflict of Interest:
  None declared.

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• Published on: 4 January 2005

  Emergency Care Practitioners should not be compared with paramedics

  • Suzanne Mason, Senior Clinical Lecturer in Emergency Medicine

  Dear Editors

  I enjoyed the article by Cooper et al.[1] and was delighted to see some evidence being published outlining the role of the Emergency Care Practitioner (ECP). However, I have some concerns about the study. I was puzzled as to why the authors chose to compare the ECPs with paramedics. The role is entirely different with ECPs being equipped with additional skills enabling them to undertake an in-d...

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  Dear Editors

  I enjoyed the article by Cooper et al.[1] and was delighted to see some evidence being published outlining the role of the Emergency Care Practitioner (ECP). However, I have some concerns about the study. I was puzzled as to why the authors chose to compare the ECPs with paramedics. The role is entirely different with ECPs being equipped with additional skills enabling them to undertake an in-depth evaluation of a patient and treat them accordingly, leaving them at home where appropriate and wihtout reference to another clinician. I am not aware that paramedics are trained to this level, and therefore cannot understand how a comparison can be made. The authors also commented on the differences in chief complaints that the ECPs attended, but surely this is the whole point of ECPs? They are specially trained to deal with minor illness and injury and therefore the reponse should be directed at these patients in order to ensure maximum benefit from the role. This paper would have been more relevant and interesting if the authors had compared the whole patient episode, rather than part of it. This may have allowed some conclusions to be drawn about the potential benefit an ECP might have for the patient in terms of time saved and appropriate clinical decisions made to avoid the emergency department.

  References

  1. S Cooper, B Barrett, S Black, C Evans, C Real, S Williams, and B Wright The emerging role of the emergency care practitioner Emerg Med J 2004; 21: 614-618

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  Conflict of Interest:
  None declared.

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