The Faculty of Pre-Hospital Care

Multi-professional pre-hospital emergency medicine programme


Developing the concept of a multi-professional pre-hospital emergency medicine (PHEM) practitioner training programme

Andy Thomas, paramedic group chair, Faculty of Pre-Hospital Care; Dan Cody, project lead for pilot scheme, Faculty of Pre-Hospital Care; Dr Phil Hyde, curriculum chair, Intercollegiate Board for Training in Pre-Hospital Emergency Medicine; Andy Thurgood, nurse group chair and elected member, Faculty of Pre-Hospital Care; Dr Colville Laird, chair, Faculty of Pre-Hospital Care; Prof David Lockey, vice chair, Faculty of Pre-Hospital Care; Dr Rod Mackenzie, examinations committee chair, Faculty of Pre-Hospital Care; Prof Sir Keith Porter, immediate past chair, Faculty of Pre-Hospital Care. Email for correspondence:

Published in the Journal of Paramedic Practice. Journal of Paramedic Practice • Vol 8 No 5 223 Faculty of Pre-Hospital Care Position Statement © 2016 MA Healthcare Ltd

What is pre-hospital emergency medicine (PHEM)?

The term ‘pre-hospital emergency medicine’ (PHEM) covers a wide range of medical conditions from minor illness and injury to life-threatening emergencies. Pre-hospital interventions therefore also range from simple first aid to advanced emergency care. Clinical providers may be first responders, technicians, paramedics, nurses and doctors. All of this activity may take place in urban, rural or remote settings (Intercollegiate Board for Training in Pre-Hospital Emergency Medicine, 2015). 

PHEM practice relates to the emergency response, primary scene transfer and secondary emergency transfer functions within prehospital care at the level of the consultant (level 8) practitioner (Skills for Health, 2015), with focus on the area of clinical care required for the seriously ill or injured patient. The key drivers include ensuring consistency in the provision of PHEM services, ensuring equality of access, service delivery, quality and clinical governance.

The PHEM curriculum and assessment system

The PHEM curriculum and assessment system was designed by the Faculty to meet the requirements of General Medical Council (GMC)
medical sub-specialty regulations but also to support multi-professional training programmes. PHEM was subsequently approved by the GMC, in 2011, as a medical sub-specialty to some existing medical specialties. Work has been ongoing since that time to explore the possibility of non-doctor access to the PHEM curriculum and examination process. In July 2015 the Faculty of Pre-Hospital Care supported, in principle, multi-professional access to the PHEM curriculum and examination process for appropriately trained and experienced paramedics and nurses.

The vision

The Faculty has and will continue to be an organisation which promotes PHEM provided by skilled, inclusive, multi-professional providers. The consistency of PHEM delivery is not yet universal and adaptation of current models is required to ensure that the needs of the patient are consistently met. This includes support for development of a multi-professional PHEM workforce. The Faculty supports the concept of multi-professional PHEM practitioner training programmes that follow defined career frameworks (College of Paramedics, 2015).

It is envisaged that these programmes will train a small number of appropriately experienced practitioners, in a robust and tightly governed programme, provided and supervised by local education providers, from a national framework to
ensure standardisation. 

Current position 

In November 2015, with close support from the College of Paramedics and Royal College of Nursing, and guidance from the curriculum committee of the Intercollegiate Board for Training in Pre-hospital Emergency Medicine (IBTPHEM), the Faculty endorsed the concept of the development of a multi-professional training programme in PHEM and the development of pilot training schemes to test the concept.

Next steps

It is not within the remit of the Faculty to develop or supervise training programmes. Hence the Faculty, the College of Paramedics and the Royal College
of Nursing, intend to work collaboratively with educational providers and clinical organisations to develop pilot training programmes. The aim being to support the development of multi-professional PHEM practitioner training programmes that follow a defined career framework (College of Paramedics, 2015). It is intended that ongoing consultation regarding this innovation, to ensure that safe, robust
and practical training is developed, will take place with the support of the curriculum committee of the Intercollegiate Board for Training in Pre-Hospital Emergency Medicine, Health Education England and Local Education Training Boards.


College of Paramedics (2015) Post-Registration Career Framework. 3rd edn. College of Paramedics, Bridgwater Intercollegiate Board for Training in Pre-Hospital Emergency Medicine (2015) Sub-Specialty Training in Pre-Hospital Emergency Medicine: Curriculum and Assessment System. Intercollegiate Board for Training in Pre-Hospital Emergency Medicine, London Skills for Health (2015) Career Framework. (accessed 15 April 2016)

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