TY - JOUR T1 - The giraffe: the emergency care practitioner; Fit for purpose? The East Anglian experience JF - Emergency Medicine Journal JO - Emerg Med J SP - 365 LP - 366 DO - 10.1136/emj.2004.014407 VL - 21 IS - 3 AU - R Doy AU - K Turner Y1 - 2004/05/01 UR - http://emj.bmj.com/content/21/3/365.abstract N2 - This short report describes the background and development of the new emergency care practitioner (ECP) programme run by the East Anglian Ambulance NHS Trust (EAAT) and the Health Schools of the University of East Anglia (UEA). The programme encompasses the emerging national competencies for the ECP. Although the first pilot cohort of 10 paramedics has yet to complete the course at the time of writing, the background and lived experience of developing and providing the programme are discussed. The article also considers a number of the opportunities and threats that may arise with the imminent transfer of the first cohort to an operational role within the NHS. Throughout the NHS, rapid change, emerging roles, and changing professional and practice boundaries are becoming the norm for practitioners.1–4 This has had a widespread impact among educationalists who have been called upon, often with short notice, to help design and implement robust courses and programmes to develop cohorts of people to work in new roles and innovative ways. Primary care and emergency services are no exception, with the ECP assuming a key emerging role as the pressures to prevent admission and the service consequences of the GMS contract, among other drivers, become apparent. The notion of a paramedic practitioner has been floated for a number of years. Initial work in Coventry and Warwickshire involving extended skills within a small group of nurses and paramedics developed this concept further.5 It is important to emphasise from the outset that while the ECP role has some similarities to both the undefined paramedic practitioner concept and the more established paramedic, nurse practitioner, and emergency nurse practitioner roles it is in reality something quite different and innovative. To quote students in the first cohort of the East Anglia Programme: “the emergency care practitioner occupies … ER -