2013: the year in review

As paramedics across the country are recovering from the busiest shift of the year, the Journal of Paramedic Practice thought it would look back over 2013 and consider some of the notable events that occurred, both good and bad.

The beginning of 2013 will be remembered by most for the tragic loss of Roland Furber, President of the College of Paramedics, who passed away on 4 February. Roland and his late wife Carol were known for the huge contribution they made to the paramedic profession and the establishment of the professional body, which was then the British Paramedic Association (BPA). As the inaugural chief executive of the BPA, Roland made an enormous impact on the founding of the profession.

February also saw the release of the final report of the Mid Staffordshire NHS Foundation Trust Inquiry chaired by Robert Francis QC, which though not directly affecting paramedics, raised a number of important questions concerning the care of those who are older and more vulnerable. Perhaps more than anything it highlighted the need for a cultural change within the NHS, where patients are placed at the centre.

One of the most notable events of the past year was the long-awaited publication of the UK Ambulance Services Clinical Practice Guidelines 2013, which was issued following lengthy development with JRCALC and National Ambulance Service Medical Directors. The first major re-write since 2006, it features a number of significant changes in terms of guidance for clinical care. Work is already underway scoping future editions and updates, as can be seen in the obstetrics and gynaecology update published in this issue.

April saw the new health and care system in England become fully operational, with its ambitious aims to deliver the content laid out in the Health and Social Care Act 2012.

August saw the publication of the end of study report for the Paramedic Evidence Based Project (PEEP). Commissioned as a result of the growing interest in the delivery of paramedic education and training, the project called for the introduction of a national education and training framework for paramedics.

Perhaps the biggest piece of news came with Sir Bruce Keogh’s report on the first stage of his review into urgent and emergency care, published 13 November, which presented a significant step in the progression of the paramedic profession. Sir Bruce’s call for the development of 999 ambulance services so that they become mobile urgent treatment services, illustrated an appreciation of the skillset of paramedics and their potential in the delivery of pre-hospital care.

Finally, 2013 marked the five-year anniversary of the Journal of Paramedic Practice, which was launched in October 2008. On behalf of the journal I would like to thank the editorial board, the consultant editors, all those who have contributed to the journal, helping to make it an informative learning resource, and most of all, you the readers, without which this publication would not be possible. I look forward to another exciting year and wish you all the best for 2014.

Taken from Journal of Paramedic Practice, published 10 January 2014.

Legislation to be amended to extend use of PGDs

The Medicines and Healthcare products Regulatory Agency (MHRA) and the Department of Health are amending medicines legislation to enable the continued use of patient group directions (PGDs) in the new organizational structures of the health system.

A PGD is a legal mechanism that allows named registered health professionals to supply and/or administer medicines to groups of patients that fit the criteria laid out in the PGD.

As a result of the Health and Social Care Act 2012, a number of NHS bodies that can currently authorize PGDs—in particular, primary care trusts (PCTs) in England—will no longer exist from April 2013. The aim of the amended medicines legislation is to enable clinical commissioning groups (CCGs) and local authorities to authorize PGDs.

The legislative amendments will also ensure that existing PGDs will continue to be legal after their expiry on 31 March 2013 and until CCGs or local authorities are able to put in place new systems for authorizing them.

Rebecca Cheatle, primary and community healthcare adviser at the Royal College of Nursing (RCN), sits on the Department of Health’s PGDs committee. Ms Cheatle told Practice Nursing: “Revisions to the Medicines Act will ensure that practice nurses [and other health professionals] using existing PGDs are not working outside the law after 31st March 2013.”

Gillian Champion, co-chair, Exeter sub-locality CCG, said: “This information is long overdue and is somewhat lacking in detail. Nurses need to know who is going to keep them updated, who is going to authorise new PGDs. While these arrangements are being set up, practice nurses will be left professionally unsupported.”

Revised guidance and a framework of competencies for the use of PGDs are due for publication in April 2013, taking into account the changes to legislation and organizational structures. In the meantime, the National Prescribing Centre’s 2009 guidance on PGDs remains valid.

Taken from Practice Nursing, published 21 Jan 2013.