The urgent and emergency care review being led by NHS England will conduct a national pilot in the spring to trial employing pharmacists in an emergency department setting.

In a report to NHS England’s December board meeting, taking place today, Sir Bruce Keogh has given an update on the work underway, which includes a greater role for ambulance services to reduce the burden on A&Es.

The national pharmacist trial will begin in spring next year and will build on a pilot in the West Midlands which has focused on pharmacy triage, advanced clinical pharmacy training and clinically enhanced prescribing within the emergency department.

The review will also encourage ambulance services to deal with more patients over the phone or at the scene. Meanwhile Health Education England will introduce a single accredited curriculum for paramedic training.

Clinical commissioning groups will be given advice next summer on how to identify hospitals that should have responsibility for delivering networked specialist services. CCGs will also be asked to analyse their areas and decide the “geographical boundary and composition of their urgent and emergency care networks”.

Commissioners and providers will be expected to improve self-care advice for patients managing physical and mental health acute or long term conditions, with the support of NHS England.

A new commissioning for quality and innovation payment will be introduced in 2015-16, which aims to “incentivise” treatment closer to home rather than in hospital.

Guidance will also be published to “ensure consistency” in referring patients between clinicians to avoid “re-triage”.

District and general practice nursing will be looked at with recommendations published next autumn which will set out “competencies and skills” that should be achieved and the need to address staffing levels. The intention is to make it easier for clinicians in the community to deliver treatment in primary care settings as an alternative to A&E.

NHS England is also working with the Academy of Medical Royal Colleges to publish commissioning guidance for next summer on how to increase direct access to specialists, both from senior hospital clinicians and from general practice. This aims to reduce emergency admissions and reduce the time it takes to receive a specialist opinion.

NHS England and Monitor will develop a new payment approach that “supports new ways of delivering urgent and emergency care as a coordinated system”. Further detail will be published at the beginning of next year.

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