SKILLmix-ED (Phase One)
Research type
Research Study
Full title
Implementation of the non-medical practitioner workforce into the emergency and urgent care system skill-mix in England: a mixed methods study of configurations and impact
IRAS ID
294203
Contact name
Mary Halter
Contact email
Sponsor organisation
Joint Faculty, Kingston University and St George's University of London
Duration of Study in the UK
0 years, 11 months, 28 days
Research summary
The impact of different non-medical practitioner skill-mix in Emergency Departments and Urgent Treatment Centres
Demand for emergency care services is growing every year. One solution is to employ ‘non-medical practitioners’. We need to know what balance - known as ‘skill-mix’ - of nonmedical practitioners, doctors and nurses is best. This study will explore this in England.
We will split the study into four phases over 30 months, and this application is the Phase One only.
Phase One (months 0-12) investigates what skill mix exists in emergency departments, views as to benefits and challenges and information about the levels of independence and supervision required by different types of non-medical practioners at different stages of their careers and with different types of patients. This phase includes a) interviewing senior NHS clinicians, managers, commissioners and lay representatives who employ or have an interest in the emergency and urgent care workforce to understand their views on skill mix and the employment of non-medical practitioners in emergency departments and b) observing non-medical practitioners and foundation years doctors at work in emergency departments to understand the variation in supervision of their work by senior doctors. The findings from these two nested studies, together with the results of our systematic review (c) and analysis of publicly available emergency service data (d), inform the methods for the next phases of our research. In a consultation process with patients, practitioners , clinicians we will develop a system for classifying ‘skillmix’ i.e. the proportion of doctors and non medical practitioners which we will then apply in later phases of the study to examine the impact on patient experience and outcomes. We will apply for ethics and HRA review of the later phases separately. The overall purpose of the study is to provide information to managers as to the most appropriate and effective skill-mix in emergency departments.
REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
21/NE/0071
Date of REC Opinion
1 Apr 2021
REC opinion
Favourable Opinion