European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Critical care paramedics (CCPs) have been introduced by individual ambulance trusts in England, but there is a lack of national coordination of training and practice. We conducted an online survey of NHS ambulance services to provide an overview of the current utilization and role of CCPs in England. The survey found significant variations in training, competencies and the working patterns of the ∼90 CCPs working in five ambulance services. ⋯ The CCP model established in five ambulance services in England is unique within Europe. With increasing numbers of CCPs, concerns about lack of supportive scientific evidence and clinical need should be addressed. Optimal delivery of prehospital critical care in England remains controversial.
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Care providers need accurate information to help them effectively manage patient flow in emergency departments (EDs) and deliver high-quality care within time constraints. Data should alert care providers to clinical risk and poor patient experience. In England, NHS A&E guidance proposes, among others, three measures to understand the distribution of waiting times in EDs - the median wait, 95th percentile and maximum wait. This study explores how well these three measures monitor performance and the potential added value of scatterplots. ⋯ The use of scatterplots could help care providers better understand the distribution of waiting times in EDs, identify where EDs struggle to deliver care against time constraints and highlight poor patient experience and prompt action to address concerns.