SkillMix-ED: Re-shaping the urgent and emergency care workforce
Shaping the future of emergency care with evidence-based workforce solutions.
SkillMix-ED: workforce innovation in emergency care
What is the study about?
The SkillMix-ED study is transforming how emergency departments (EDs) and urgent treatment centres (UTCs) balance their workforce.
By exploring the best skill-mix of doctors, nurses and non-medical practitioners, the study identifies staffing strategies that enhance patient care and support healthcare professionals.
This research is critical as the demand for emergency care grows, alongside a shortage of doctors. While non-medical practitioners have supported EDs for over 20 years, evidence about the ideal balance between roles remains scarce.
How are we conducting the research?
The study spans four phases over 3.5 years, beginning in March 2021:
- Mapping current staffing models
- Analysis of existing data, policies and interviews with NHS clinicians, managers and public representatives.
- Classifying skill-mix and independence levels of non-medical practitioners.
- Evaluating national data (2017–2021)
- Reviewing patient outcomes tied to different staffing configurations, with a focus on ED return visits within one week.
- Deep dive into six case studies
- Local data collection, clinical records analysis and surveys of staff and patients to understand skill-mix effects.
- Bringing it all together
- Compiling findings to recommend optimal workforce configurations, ensuring the best outcomes for patients, staff and the NHS.
What will the study achieve?
The findings will guide:
- Healthcare professionals and managers in making evidence-based workforce decisions.
- Policymakers on strategies to improve efficiency and patient care.
- The wider healthcare community on cost-effective staffing models.
We will share updates through newsletters, social media and conferences, ensuring the results reach practitioners, patients and public groups.
Meet the team
Dr Mary Halter, Associate Professor of Emergency Research (Joint Chief Investigator)
Professor Vari M. Drennan, Professor of Health Care and Policy Research (Joint Chief Investigator)
Other key members: Researchers, statisticians and clinical experts from leading institutions like ÂÌñ»»ÆÞ, St George’s University Hospitals NHS Trust and the University of Surrey.
Key projects under SkillMix-ED
Implementation of the non-medical practitioner workforce
- Focus: Exploring how non-medical practitioners enhance ED skill-mix.
- Award value: £776,000 (NIHR-funded)
- Method: Mixed-methods study analysing national data and conducting case studies on patient and staff outcomes.
TRIage Model (TRIM) study
- Focus: Evaluating ambulance triage models for COVID-19 999 callers.
- Award value: £358,400 (Medical Research Council-funded)
- Collaboration: Swansea University, Public Health Wales, and others.
ÂÌñ»»ÆÞ data protection privacy notice for the study
In this research study we will use information from you. We will only use information that we need for the research study. We will let very few people know your name or contact details, and only if they really need it for this study.
Everyone involved in this study will keep your data safe and secure. We will also follow all privacy rules.
We will make sure no-one can work out who you are from the reports we write.
What is this privacy notice about?
This privacy notice explains how ÂÌñ»»ÆÞ ("we", "our", "us") collects, uses and shares your personal data (information) and your rights in relation to this data. The notice relates to our processing of personal data we hold about you regarding the above-named study ("you", "your").
ÂÌñ»»ÆÞ is the data controller of your personal data and is subject to the General Data Protection Regulation (the "GDPR") and the UK Data Protection Act 2018. We are listed on the Information Commissioner's Office (ICO) register of fee payers. A copy of our Data Protection Policy is available online.
This privacy notice answers the following questions:
The study is a National Institute of Health Research funded study exploring what balance – the 'skill mix' - of non-medical practitioners, doctors and nurses is best in emergency departments and urgent treatment centres.
We will need to use information from you for this research project. We will collect in a number of ways, for example:
- directly from your interview responses should you participate in the research
- when you communicate with us by letter, telephone or email
- from your contact details if you informed us you wish to receive study updates.
We will keep all information about you safe and secure.
This information will include:
- your name and contact information such as work and/or personal email address or phone number (interviews or receiving study updates)
- information relating to your professional status such as your job title and clinical or managerial expertise (staff interviews only).
We use your personal data in different ways depending on the stage of your interaction with us. For example, we process your contact information to arrange a suitable interview time with you. We then process the personal data you choose to provide via the interview and/or for staying in contact for study updates for the purposes of our study.
Further details about the use of interview and/or staying in contact are provided in the information for participants that we have also sent to you.
The legal basis for processing your personal data is "task in the public interest".
We believe that we have a legitimate interest in conducting academic research and have considered the potential impact on you. You can ask us to stop processing your personal data and we will remove them.
We will share your personal data with a limited number of people internally within our research team where there is a legitimate reason for their receiving the information i.e., to make contact with you.
Please note that no personal data will be passed on to the study funders as any information provided to them will be anonymised.
Your personal data will be kept for the time necessary to complete the analysis for the research project. It will then be anonymised. The consent to participate in the research form with your name and signature will be kept in a separate electronic file to the study data for ten years after the end of the study and then destroyed (2034). We will ask for your consent separately for contact details if you wish to receive copies of any published journal article (anytime up until December 2025) and/or the final report (expected to be published by NIHR 2025).
We will hold your data only for a short period of time, which reduces the likelihood that any data will become inaccurate. Furthermore, all personal data will be provided by you.
You can stop being part of the study at any time, without giving a reason, but we will keep information about you that we already have.
Under the GDPR and the UK Data Protection Act 2018, you have the following rights:
- to access from us the personal data we hold about you
- to require us to correct the personal data we hold about you if it is incorrect
- to require us to erase your personal data
- to require us to restrict our data processing activities (and, where our processing is based on your consent, you may withdraw that consent, without affecting the lawfulness of our processing based on consent before its withdrawal)
- to receive your personal data, which you provided to us, in a structured, commonly used and machine-readable format and the right to transmit that data to another controller
- to object, on grounds relating to your particular situation, to any of our particular processing activities where you feel this has a disproportionate impact on your rights
- to not be subject to a decision based solely on automated processing, including profiling, which has a legal effect on you.
Please note that the above rights are not absolute and we may be entitled to refuse requests where exceptions apply.
If you have given your consent and you wish to withdraw it, please contact Dr Mary Halter [email protected].
You can find out more about how we use your information
- at
- by asking one of the research team you are in contact with
- by sending an email to [email protected] or [email protected]
- by sending an email to the Data Protection Officer: [email protected]
- by writing to: Data Protection Officer, Vice Chancellor's Office, River House, 53–57 High Street, Kingston upon Thames, Surrey KT1 1LQ.
If you wish to request access to the personal data we hold about you please use the contact above in the first instance. Alternatively, you can use the ÂÌñ»»ÆÞ Subject Access Request Form available online.
If you are not satisfied with how we are processing your personal data, you can make a complaint to the Information Commissioner.
You can find out more about your rights under data protection legislation from the Information Commissioner's Office website.
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