Skill mix changes and new roles in emergency and urgent care

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NHSNational Institute for Health ResearchIn this article…• Evidence on the introduction of new roles in emergency and urgent care• Evidence on skill mix changes in emergency and urgent care• Need for further research into the right skill mix in emergency and urgent careAuthor Chiara Dall'Ora is research fellow in nursing workforce; Catherine Pope is professor of medical sociology; Robert Crouch is consultant nurse and honorary professor, emergency care; Peter Griffiths is chair of health services research; all at NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton; Mark-Alexander Sujan is associate professor of patient safety at Warwick Medical School, University of Warwick. Economic constraints and increasing demand for healthcare have led to the development of new roles in both emergency and urgent care settings. A core aim of many of these new roles is cost reduction by labour substitution, but they are also introduced to improve care quality. This article summarises the evidence of the impact of introducing new roles and changing the skill mix on patient, staff and cost outcomes.Citation Dall'Ora C et al (2018) Skill mix changes and new roles in emergency and urgent care. Nursing Times [online]; 114: 1, 26-27.Key pointsNew roles have been introduced in emergency and urgent care to face increasing demandThey often involve nurses taking on responsibilities of doctors or support staff being added to nursing teamsThese new roles are often poorly defined and lack standardisationThe wider effects of these new roles and changes in skill mix are poorly researchedMore research is needed to establish the best approach to matching limited resources to rising demand for emergency services

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