SkillMix-ED (Phases Two and Three)
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 (Phases two and three)
IRAS ID
319755
Contact name
Mary Halter
Contact email
Sponsor organisation
Kingston University
Clinicaltrials.gov Identifier
Clinicaltrials.gov Identifier
ClinicalTrials.gov, NCT04770766
Duration of Study in the UK
0 years, 9 months, 31 days
Research summary
Demand for urgent and emergency care services is growing every year. There are not always enough doctors, and staff leave or become unwell in high numbers. One solution is for emergency departments and urgent treatment centres (EDs/UTCs) to employ ‘non-medical practitioners’ who undertake some of the work of doctors. This study will explore what balance - the ‘skill-mix’ – of non-medical practitioners, doctors and nurses is best in EDs/UTCs in England. It is split into four phases. Phase One has produced three outputs: skill-mix ratios for all National Health Service (NHS) organisations in England; a tool for measuring the interdependence of non-medical practitioners and other clinical staff; a logic model of the ways different mixes of staff in different contexts impact on patient care and staff well-being. This protocol is for Phases Two and Three. Phase Two will use figures regularly collected from all NHS Trusts in England 2017-2021, to assess whether different skill-mixes lead to different patient outcomes. We will look especially at the number of patients returning to the ED/UTC within a week. This analysis will not include detailed information on the context of each ED/UTC, which is what Phase Three will investigate in up to six EDs/UTCs. We will collect in-depth local data to add to the national data of Phase Two. These local data will include anonymous staffing rotas and anonymous patients’ clinical records to give more detail about skill-mix in the organisations and patient outcomes. We will use the tool developed in Phase One to assess how interdependently different types of practitioners work when assessing and treating patients with different levels of urgent or emergency problems. We will survey and interview patients to understand their experiences, and interview staff for their views. We will use our evidence and conclusions to inform decision-makers about staffing in EDs/UTCs.
REC name
London - Surrey Research Ethics Committee
REC reference
22/LO/0791
Date of REC Opinion
10 Jan 2023
REC opinion
Further Information Favourable Opinion