Since 2001 government policy has created a new set of professionals, Emergency Care Practitioners (ECPs), and a new style of urgent healthcare provision to support the vision of a healthcare service designed around the patient. ECPs are paramedics and nurses with additional training to treat patients at home, in minor injuries units or to stabilise patients for transport to specialist clinical units. Although professional training has been developed for ECPs there has been no research to look at the technologies needed to support this new role. This project is looking at emergency and urgent care work in detail. We propose that supporting technologies can be delivered as Smart Pods with three components: a vehicle/docking system, a treatment (vehicle) unit and a treatment package system (equipment and consumables). The first stage of the project is to model the operational systems to determine the distribution of the vehicle/docking systems for the Smart Pods to deliver the right care at the right time in the right place. At the same time we will be working with clinical partners in the East Midlands and South West to look at 4-6 treatment types (including chest pain, minor head injuries, minor illnesses and falls). These treatment types will be analysed in detail in A&E departments, minor injuries units and ambulance services to look for similarities and differences in clinical practice to provide the framework for the treatment packages and initial data for the layout in the treatment (vehicle) unit. We will propose a standardised pathway for the treatment types and will use a simulation mannequin to test the clinical treatment unit layout in a laboratory with doctors, nurses and ECPs.We will start working on the design of the vehicle by reviewing the current systems and looking at distribution and delivery systems in other industries, e.g. military, car breakdown services, food delivery. We will look at how new emergency care vehicles are ordered, purchased and manufactured and compare this with other low-volume vehicle manufacturing (e.g. Lotus, Maclaren) to help us develop viable solutions. This information will be used to look at both manufacturing and purchasing issues to explore if the Smart Pods concept is viable.Vehicle engineering and associated systems options will be surveyed, in particular chassis/drive chain and intelligent vehicle technologies and we will consider sustainability issues in terms of full life-cycle energy usage. Computer models and animation scenarios covering the full range of proposed SmartPod applications will be developed. The final part of this first phase of the project will start to consider issues of implementation in more depth with patient groups representing people affected by a range of urgent and emergency care conditions. We will also consult members of the lay public, clinicians, and those involved in the planning for, managing, and evaluating urgent and emergency care to investigate views on change in the provision of urgent and emergency care and to identify any unanticipated challenges (e.g. political, organisational, cultural) in implementing change.

Since 2001 government policy has created a new set of professionals, Emergency Care Practitioners (ECPs), and a new style of urgent healthcare provision to support the vision of a healthcare service designed around the patient. ECPs are paramedics and nurses with additional training to treat patients at home, in minor injuries units or to stabilise patients for transport to specialist clinical units. Although professional training has been developed for ECPs there has been no research to look at the technologies needed to support this new role. This project is looking at emergency and urgent care work in detail. We propose that supporting technologies can be delivered as Smart Pods with three components: a vehicle/docking system, a treatment (vehicle) unit and a treatment package system (equipment and consumables). The first stage of the project is to model the operational systems to determine the distribution of the vehicle/docking systems for the Smart Pods to deliver the right care at the right time in the right place. At the same time we will be working with clinical partners in the East Midlands and South West to look at 4-6 treatment types (including chest pain, minor head injuries, minor illnesses and falls). These treatment types will be analysed in detail in A&E departments, minor injuries units and ambulance services to look for similarities and differences in clinical practice to provide the framework for the treatment packages and initial data for the layout in the treatment (vehicle) unit. We will propose a standardised pathway for the treatment types and will use a simulation mannequin to test the clinical treatment unit layout in a laboratory with doctors, nurses and ECPs.We will start working on the design of the vehicle by reviewing the current systems and looking at distribution and delivery systems in other industries, e.g. military, car breakdown services, food delivery. We will look at how new emergency care vehicles are ordered, purchased and manufactured and compare this with other low-volume vehicle manufacturing (e.g. Lotus, Maclaren) to help us develop viable solutions. This information will be used to look at both manufacturing and purchasing issues to explore if the Smart Pods concept is viable.Vehicle engineering and associated systems options will be surveyed, in particular chassis/drive chain and intelligent vehicle technologies and we will consider sustainability issues in terms of full life-cycle energy usage. Computer models and animation scenarios covering the full range of proposed SmartPod applications will be developed. The final part of this first phase of the project will start to consider issues of implementation in more depth with patient groups representing people affected by a range of urgent and emergency care conditions. We will also consult members of the lay public, clinicians, and those involved in the planning for, managing, and evaluating urgent and emergency care to investigate views on change in the provision of urgent and emergency care and to identify any unanticipated challenges (e.g. political, organisational, cultural) in implementing change.

To maintain continuity with MATCH Phase 1, it has been requested that MATCH Phase 2 follows the current programme breakdown in terms of Projects A-F from 2008-2013 / a vision that is described below. We note that MATCH changed dramatically in creating the projects A-F and that further changes in the themes are inevitable. An overview of these themes is given below.Projects A, B and C address economic evaluation and its impact in decision-making by companies, governments and procurement agencies. We have identified a major demand for such research, but note that there is some convergence between these themes (for instance, A and C may well coalesce under the Bayesian banner). In particular, a 'methodologies' theme is likely to emerge in this. Under the former theme, a truly integrated Bayesian framework for medical devices would represent a strategically important achievement.On the other hand, the business of delivering these developments to industry, and the organisations or franchises that might ultimately provide the best vehicle for doing so, still requires further exploration and negotiation, and at this point there is considerable uncertainty about how this will best be done. However the critical element has been established, namely that MATCH can provide useful tools for, and attract significant levels of funding from industry. To this extent, the applied side of Project A-F and Project 5 might well evolve into a series of programmes designed to spin out tools, training and best practice into industry. Project 5 remains for the present because we have set it up with a framework within which company IP can be protected, and within which we can expedite projects to company goals and time scales.A similar pattern is likely to emerge from the single User project (D), where there is considerable scope for capability, and methodological development / and the size of this team needs to increase. The aim is to develop a suite of methods, guidelines and examples, describing when a given method is useful and when user needs assessment must be cost-effective. We will gain and share experience on what approach works best where. Our taxonomy will recognise circumstances where the novelty of a proposed device may undermine the validity of user needs assessment conducted before the 'technological push' has had a fair opportunity to impact on the human imagination.Moreover, new research is needed to 'glue' some of these themes together. Some of this is already included (for instance, in Projects C and D below) to link the user-facing social science with the economics, or the pathway-changing experiences (F) with formal economic evaluation, will require new, cross-disciplinary research. This type of research is essential to developing the shared view of value, which MATCH is pursuing. Similarly, integrating supply-chain decision-making and procurement elements of theme (E) with economic evaluation would represent an important element of unification.To achieve this, we will need to bring in some news skills. For instance, we are already freeing up some funding to bring in an economics researcher at Ulster; more statistical mathematical support may be needed to further develop the Bayesian theme; and we need to bolster the sociological element within the team.Finally, this vision cannot be funded entirely within a research framework, and we expect critical elements to be achieved under other funding (for instance, Theme E by the NHS, in due course).