Oral and poster presentations

001 EFFECTIVENESS OF EMERGENCY CARE PRACTITIONERS WITHIN EXISTING MODELS OF CARE IN ENGLAND

P Coleman, S Mason, C O’Keeffe, R Edlin, J Nicholl. School for Health & Related Research, University of Sheffield, Sheffield, UK

Background: Emergency Care Practitioners (ECPs) have developed in response to a “key” UK government health policy to provide flexible health care focused around patients’ needs. Drawn mainly from paramedic and nursing backgrounds, ECPs receive formal training to enable them to work across traditional boundaries in urgent care. In England, ECPs are working in different healthcare settings.

Objectives : (1) To evaluate the appropriateness, patient satisfaction and cost of ECPs compared with the usual service; (2) to increase understanding of the opportunities and challenges of ECP working in different settings; and (3) to consider whether ECP working yields cost savings.

Methods: Data were collected between March and May 2005. In three different health settings where ECPs are operational and three matched control sites without ECP working, with consent, each patient eligible to be seen by an ECP received a questionnaire at 3 and 28 days post-presentation. We also conducted telephone interviews with a purposive sample of NHS staff in each setting where ECPs were operational and used clinical data to estimate costs.

Results : 524 service users (245 ECP-attended and 279 control providers) completed a questionnaire at 3 days. After adjusting for age, sex, presenting complaint and service model, some differences were observed between ECPs working in different settings and also between the ECPs and the usual providers. Overall, ECPs carried out fewer investigations (OR 0.31), provided more treatments (OR 2.74) and were more likely to discharge patients home (OR 7.69) than the usual providers. ECP-attended patients in all settings reported being “very satisfied” with the care received (OR 2.37). The qualitative interviews confirmed commitment to developing and supporting the ECP role. In different ways, ECPs are seen to have …