Is credentialing the solution to the workforce crisis?

Abstract

With the number of patient attendances increasing, we need to address the challenges facing the emergency care workforce, particularly how the system can survive the shortage of doctors. It is a strategic priority for Health Education England (HEE) to ensure an emergency care workforce with the right numbers, skills and behaviours, that can respond to the changing patterns of service. Possible solutions include raising the number of trainees, introducing the role of physician’s associate and developing the role of advanced practitioners. These are experienced professionals with expert, evidence-based knowledge who can make complex clinical decisions for patients presenting with a wide range of life-threatening and self-limiting pathologies. However, professional and regulatory bodies have debated how safe standards of advanced practice should be developed and how staff are prepared for the role for more than three decades. Under the recently introduced Royal College of Emergency Medicine (RCEM) credentialing scheme, practitioners each complete an e-portfolio, provide evidence of at least 20 consultant assessments to a trained panel of assessors and complete a recognised life-support course. If successful, they receive a certificate and are listed on an RCEM register. The RCN has endorsed the emergency care ACP curriculum, co-produced by RCEM and HEE, while preparing to launch its own credentialing scheme for advanced nurse practitioners this month. The standardisation of advanced practice in emergency care nationally is welcome, but it will be taken up only if it is recognised by employers across the country.