Draft Clinical Practice Guidelines

England has 23 519 registered paramedics, servicing a population of 65 111 143.  That is one paramedic per 2 768 members of the English population.

In 2011, the USA had 229 454 paramedics servicing a population of 311 700 000.  That is one paramedic per 1 358 members of the USA population.

In October 2016, South Africa had 1 586 ANT paramedics registered with the HPCSA, 468 ECP providers registered with the HPCSA, and 1 082 ECT providers on the register.  That is a total of 3 136 advanced life support providers registered to service a population of 55 900 000 South Africans. This equates to only one ALS provider per 17 825 members of the South African population.

Clearly South Africa has a very serious lack of ALS providers, and too few registered institutions capable of providing ALS training. Essentially, with the current number of graduates that are produced by our existing ALS training institutions, and the number of ALS staff either retiring or emigrating on an annual basis, it will be impossible to increase the number of ALS staff members to a point where advanced life support care is consistently available throughout South Africa.

What is urgently needed in South Africa is a proactive vocational training approach in order to ensure that existing BLS and ILS providers receive further training in order to boost our ALS staff numbers.

In sharp contrast with that need, the draft Clinical Practice Guideline document that was released by the Professional Board for Emergency Care has proposed that our existing ANT staff complement should have their skills downgraded, and be limited in the care that they are able to offer to the South African population.

SAPAESA, working alongside a group of diverse and talented practitioners at the Clinical Practice Guidelines Advisory Commission recently composed and submitted a very detailed submission on the draft Clinical Practice Guidelines to the Professional Board for Emergency Care as well as the Department of Health.

The submission suggests that instead of the proposed downgrading of certain key ALS skills for ANT providers, these providers should instead undertake additional vocational training in order to upskill themselves so that they are able to provide additional ALS skills to the South African population.

This would ensure that our EMS system does not collapse due to a shortage of staff members that are the only providers available to undertake the numerous primary medical emergency cases and critical interfacility transfers that occur on a daily basis all over South Africa.

It is important for both the HPCSA and the Department of Health to remember that South Africa is terribly short of both ALS providers and ambulances, in comparison to a number of first world countries with more established emergency medical service systems.

In order to avoid a complete crisis within the emergency medical services, the Minister of Health must intervene; to ensure that our industry develops, instead of degenerating into a complete public service failure.

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