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Response to NCEPOD Measuring the units report

STRICTLY EMBARGOED – FOR RELEASE 14/06/2013 00:01

The Society for Acute Medicine: Response to NCEPOD Measuring the Units report

This report highlights the growing problem of alcohol-related illness which will be well recognised by all staff working on acute medical units (AMUs).

Dr Chris Roseveare, President of the Society for Acute Medicine (SAM) said: ‘We are delighted that NCEPOD has emphasised the importance of a multi-professional approach to the management of this complex group of patients; along with early involvement of skilled, senior clinicians this is a key principle of acute medicine, and  is emphasised in our AMU quality standards document . It is vital that all staff working in the acute medical unit are provided with the skills and resources to recognise and treat patients with alcohol-related illness’.

The commitment of SAM to this issue has been reflected in the programme for the autumn international acute medicine conference in Glasgow which features a symposium devoted entirely to the challenges of alcohol on the AMU. The session, which will be chaired by Sir Ian Gilmore, will include talks from local experts Dr Ewan Forrest and Dr Adrian Stanley on alcohol withdrawal and alcoholic liver disease.

ENDS

Note to editors:

  • Acute medicine (also known as acute internal medicine) is the specialty which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the specialty of acute medicine and represents around a thousand members
  • Copies of Measuring the Units can be downloaded from the NCEPOD website as a PDF from 14 June 2013, or ring NCEPOD on 020 7251 906

 

Contact:

Claire Charras
Communications and Marketing Executive
Society for Acute Medicine
Thursday 13 June: 07 985 49 49 65
Friday 14 June: 0131 247 3696   (Emilia Sosnowska)
communications@acutemedicine.org.uk

 

 

 

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The Society for Acute Medicine comment on Government response to Francis Report

For immediate release

19th of November 2014

Commenting on the Secretary of State’s full response to the Robert Francis QC Public Inquiry into Mid Staffordshire NHS Trust, Dr Alistair Douglas, SAM President said:

“The Society for Acute Medicine (SAM) welcomes Jeremy Hunt’s response to Robert Francis QC’s inquiry. In particular a new focus on creating a culture of patient safety and ensuring adequate staffing levels will resonate with Acute Medical Unit (AMU) staff.  The Scottish Patient Safety Program has shown the benefits of such an approach.

“The announcement of formal certification of training for healthcare assistants is of great interest and the Society has recently consulted with its members as to the appropriate definition of the role on the AMU.

“We also welcome a commitment to openness and implementing learning from complaints and safety incidents which has become lost in the bureaucracy of NHS management.”

Notes to the editors:

  • Acute medicine (also known as acute internal medicine) is the specialty which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the speciality of acute medicine and represents around a thousand members.
  • Dr Alistair Douglas is a consultant in acute medicine and nephrology at Ninewells Hospital and Medical School in Dundee and is available for interview.

Contact:

Claire Charras
Communications and Marketing Officer
The Society for Acute Medicine
communications@acutemedicine.org.uk
07 985 494 965

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New research “will shape the future of nursing workforce” in acute medicine

FOR IMMEDIATE RELEASE

Results of a new study into the profile of registered nurses working in acute medical units (AMU) will be presented at the Society for Acute Medicine’s (SAM) spring conference in Coventry today.

The research identifies some of the factors which affect recruitment and retention of nursing staff on acute medical units in the UK.

Liz Lees, the main author and consultant nurse in acute medicine at Heartlands Hospital in Birmingham said: “This is the first research of its kind which specifically focuses upon nurses who work in acute medicine. It provides an insight into the current issues but crucially it also provides ‘advance notice’ and with this an opportunity to shape the future nursing workforce”.

The primary research was undertaken over a period of a year (2010/11) and is aimed at shaping the future nursing workforce by informing of the future of recruitment and retention of AMU nurses.

Key findings:

  • Diversity of patients, challenges and teamwork were cited as morale enhancing and motivating factors.
  • 85% of acute medicine nurses said they would choose to work in acute medicine again if they had the opportunity to restart their career.
  • Registered nurses felt that career progression and staff recruitment may be affected by lack of wider recognition of acute medicine nursing outside the AMU environment.
  • The variety of work and experience gained on the AMU were cited as key factors in encouraging recruitment and retention of nursing staff to acute medicine

Main recommendations:

  • Lead nurses from AMUs should undertake a skills analysis across all nurse bandings to identify the gaps and current training needs of their staff.
  • A thorough understanding of the nurses’ workload and dependency within AMU is urgently required to keep pace with the acuity and volume of patients assessed and admitted.
  • Staffing duty rotas need to be developed to take into account the potential for burn out and high stress levels through adequate time for staff development and consideration of CPD with each new rota.
  • All AMUs should consider the development of advanced nursing roles .

Dr Chris Roseveare, SAM President said: “Nurses are the linchpin of every acute medical unit; it is essential that we develop and sustain a high quality nursing workforce in acute medicine. This research has identified some vital factors which are needed to ensure the recruitment and retention of this key group of hospital staff. I am delighted that we are able to launch this document at our spring meeting and will be encouraging all members of the AMU team to share these findings as widely as possible”

A participant in the survey with 21 years of experience in acute medicine said: “I feel that ALL student nurses should be given the opportunity to work within acute medicine to gain an insight into the ethos of the clinical area.”

ENDS

Note to editors:

  • Acute medicine (also known as acute internal medicine) is the specialty which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the specialty of acute medicine and represents around a thousand members.
  • Liz Lees is a consultant nurse in acute medicine and has 21 years registered nursing experience, with 14 years spent in acute medicine.  Liz is a nurse representative on the Society for Acute Medicine council and the sole editor of two multi-professional books and author of a toolkit in collaboration with the Department of Health.
  • Dr Myers, co-author of the study trained as a general nurse at the Royal Infirmary of Edinburgh and undertook specialist training in general intensive care at Guy’s Hospital in London. She has two research degrees and a PhD from Glasgow Caledonian University.
  • The research was done in collaboration with pH Associates with funding from Imperial College London, via Professor Derek Bell.
  • Liz Lees is available for interview.
  • The research can be accessed here

Contact:

Claire Charras
Communications and Marketing Executive
Society for Acute Medicine
07 985 49 49 65
0117 983 0542
acutemedicinecomms@gmail.com
www.acutemedicine.org

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Right Patient, Right Bed

EMBARGOED UNTIL 00.01 HOURS THURSDAY 9 MAY 2013

Right patient, right bed

A new toolkit from the Royal College of Physicians for the recognition and care of seriously ill patients recommends that patients admitted as emergencies should only transfer out of the acute medical unit to a ward area that has facilities to meet their clinical needs. The toolkit is being launched today (Thursday 9 May) at the Society for Acute Medicine spring conference in Coventry.

With emergency departments and acute medical units currently under considerable strain due to rising numbers of patients being assessed and admitted, there is great pressure to move patients rapidly to beds on wards throughout the hospital.  The toolkit recommends the use of NEWS – the National Early Warning Score, launched by the RCP in 2012, in order to rapidly identify patients who are severely ill or at risk of sudden deterioration. The sickest of these patients should be transferred to the hospital’s intensive care unit or high dependency unit.

The RCP is concerned about those patients identified as requiring an intensity of monitoring and care greater than that available on a standard medical ward.  More enhanced care beds (level 1 beds), with higher nurse to patient ratios, should be available on acute medical units. In addition, hospitals should designate enhanced care beds on selected medical wards that manage acutely ill patients.

The medical patient at risk: recognition and care of the seriously ill or deteriorating medical patient, is the sixth in the series of RCP Acute Care Toolkits.  The toolkit puts NEWS  – a ‘track and trigger’ scoring system for physiological measurements – at the heart of the initial assessment of patients admitted as an emergency. Repeated NEWS values ‘track’ the patient’s progress and, in the event of a deterioration, ‘trigger’ an escalation in medical and nursing care.  The score also guides the intensity of care required and the clinical area and staffing level best able to provide this care at any time point during the hospital stay.

Recommendations for assessment:

  • All patients should have NEWS measured on admission and as part of every subsequent clinical assessment.
  • Systems must be in place to ensure timely and appropriate responses to NEWS.
  • NEWS >6 is coded red which means that an immediate review of the patient by a senior doctor is required and the patient assessed for potential transfer to the ITU. Patients with NEWS 5-6 are coded amber, require urgent medical review and may benefit from transfer to an enhanced care medical bed.
  • All doctors should be aware of red flag scenarios – symptoms and signs of severe illness which may not be detected using NEWS, for example cardiac chest pain.
  • NEWS should be used as an aid to clinical assessment but not as a substitute for competent clinical judgement.
  • Concern about a patient’s clinical condition should always override the calculated score from NEWS when considering the need to escalate the level of care.
  • Patients must always be managed in clinical areas appropriate to their care needs.

Recommendations – right patient, right bed:

  • No patient should be transferred from the AMU to a ward which is unable to meet their clinical requirements.
  • All hospitals managing acutely ill medical patients should have adequate provision of level 1 medical beds (enhanced care beds).
  • It is recommended enhanced care beds (level 1) should be embedded on Acute Medical Units for the management of newly admitted patients who are acutely ill but do not require ITU care.

Dr Rhid Dowdle, lead author for the toolkit said:

‘One of the major drivers for this toolkit was the identification of shortcomings in the care of seriously unwell medical patients by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD). I hope the recommendations we have made will, if implemented, improve the care of this vulnerable group of patients.’

Dr Mark Temple, RCP acute care fellow and toolkit series lead, said:

‘The early recognition of the patient who is deteriorating or at risk of deterioration, provides the best opportunity to intervene rapidly and effectively. Acute care toolkit 6 focuses on the use of the National Early Warning Score (NEWS) to detect changes in the severity of a patient’s illness and links this to a series of actions by nurses and doctors to escalate care. The toolkit deals with best practice in the management of acutely ill patients throughout the hospital and is fundamental to improving patient outcomes and saving lives”.

Dr Chris Roseveare, Society for Acute Medicine president said:

“I am delighted that we are able to launch this key document at the Society for Acute Medicine spring conference this week. Ensuring that seriously unwell patients receive prompt, safe care should be a top priority for all staff working on the acute medical unit. The toolkit highlights the importance of early recognition, followed by rapid, senior review for this high risk group of patients; this will be a key message from the three speakers at our opening symposium today. It is crucial to ensure that such patients are managed in the most appropriate ward setting, by staff with the skills to provide this care. Many acute medical units already provide such facilities, and the next generation of acute medicine consultants will all undergo a formal period of critical care training to ensure that these skills are embedded into the AMU team”.

Notes to editors:

  • A PDF of the toolkit is attached to this email. The toolkit will be available to download from the RCP website as of 00.01 Thursday 9 May.
  • For further information please contact RCP Head of PR Linda Cuthbertson on 020 3075 1254, 07748 777919 or linda.cuthbertson@rcplondon.ac.uk.
  • The Society for Acute Medicine Spring Conference takes place in Coventry on 9/10 May.  For further information please contact Claire Charras, SAM Marketing and Communication Executive on 07985 494 965 or acutemedicinecomms@gmail.com. Conference website:

https://www.eventsforce.net/eventage/frontend/reg/thome.csp?pageID=14409&eventID=43&eventID=43

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Seven-day Present Consultant Care

STRICTLY EMBARGOED – FOR RELEASE: 04/12/2010 00:01

7-day consultant present care: ‘A ground-breaking document, which will shape the future of care for patients in hospital’

The Society for Acute Medicine (SAM) has been a strong advocate of seven day consultant-led care for patients who are admitted to hospital in an emergency. The recent publication of the SAM quality standards document and toolkit for delivery of 12-hour consultant presence on the acute medical unit (AMU) reflects the importance of early consultant involvement in improving outcomes for patients.

The Seven Day Consultant Present Care report, produced by the Academy of Medical Royal Colleges (AoMRC) goes one step further, recognising the importance of seven day consultant-led care in all specialty areas for patients throughout their hospital stay. The report also stresses the need to provide seven day access to appropriate investigations and treatments and the crucial role provided by support services both in hospital and in the community.

The report sets three patient-centred standards to guide of the delivery of consistent care, seven days a week:

  • Hospital inpatients should be reviewed by an on-site consultant at least once every 24 hours, seven days a week, unless it has been determined that this is not necessary for the patient.
  • Consultant-supervised interventions and investigations along with reports should be provided daily if the results will change the patient’s care before the next ‘normal’ working day.
  • Support services, both in hospitals and in the community setting, should be available daily to ensure that the next steps in the patient’s treatment can be taken.

Dr Chris Roseveare, SAM President and co-chair of the Academy seven-day Working Sub-Group said: “This is a ground-breaking document which will shape the future of care for patients in hospital in the UK. It is well recognised that the number of consultants in most hospital areas is lower during the weekend than during weekdays; access to certain investigations, treatments and support services are equally limited. It has also been demonstrated that patients admitted to hospital at a weekend are more likely to die from their illness. Publication of this document, supported by all the Medical Royal Colleges, demonstrates the commitment of hospital specialists to address this problem.

“Delivering these standards will be an enormous challenge for the Health Service, particularly for medical specialities which care for large numbers of patients in hospital. It is vital that a high quality weekday service is also maintained, which inevitably will require an expansion of the numbers of consultants in many areas. The document recognises that this will take time and financial investment, as well as changes in work patterns and hospital configuration. However the benefits for patients are likely to be substantial.

“We heard yesterday about the challenges of overcrowding in our hospitals; capacity problems frequently occur on Mondays due to a fall in discharges over weekends. A seven day consultant-led service in hospitals and greater community support at weekends will be a major step towards easing this pressure”.

ENDS

Notes to the editors:

  • Acute medicine (also known as acute internal medicine) is the specialty which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the speciality of acute medicine and represents over a thousand members.
  • Dr Roseveare has been an acute medical consultant in a large teaching hospital since 1999, and was co-chair of the seven-day working subcommittee which advised the AoMRC Steering group in producing these guidelines.
  • The report is available to download from 00.01 4 December 2012 at http://aomrc.org.uk/publications/reports-a-guidance.htm.
  • SAM’s previous statements on consultant presence seven days a week are available on our website, under Position Statements and Media Room.

Contact:

Claire Charras
Communications and Marketing Executive
Society for Acute Medicine
07 985 49 49 65
0117 983 0542
acutemedicinecomms@gmail.com
www.acutemedicine.org

 

 

 

 

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“Teaching must not be relegated down the list of priorities”, says SAM President

STRICTLY EMBARGOED – FOR RELEASE: 27/11/2012 00:01

“Teaching must not be relegated down the list of priorities”, says SAM President.

The fifth in the RPCL’s Acute Care Toolkit series provides an invaluable guide to enable staff to find the right balance between teaching and delivering high quality care for patients on the Acute medical units (AMU). The Society for Acute Medicine (SAM) supports the recommendations contained in this toolkit and recommends their adoption by all acute medical units across the UK.

Dr Chris Roseveare, Society for Acute Medicine President said: “Acute medical units provide fantastic learning opportunities for all healthcare professionals. However, the staff are invariably under huge pressure to provide rapid assessment and treatment for the large numbers of patients arriving on the AMU on a daily basis. Teaching must not be relegated to the bottom of the list of priorities; if this happens, such opportunities will be lost. Providing a high quality acute care service for patients and a high quality education for the next generation of healthcare professionals must go hand in hand. This toolkit provides a major step forward in achieving the correct balance between these two vital areas of our practice”.

ENDS

Notes to the editors:

  • Acute medicine (also known as acute internal medicine) is the specialty which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the speciality of acute medicine and represents over a thousand members.
  • Dr Roseveare has been an acute medical consultant in a large teaching hospital since 1999.
  • The full document is available on the RCP website.

Contact:

Claire Charras
Communications and Marketing Executive
Society for Acute Medicine
07 985 49 49 65
0117 983 0542
acutemedicinecomms@gmail.com
www.acutemedicine.org

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SAM response to the Shape of Training report

Official response by Dr Alistair Douglas & Dr Mark Holland to Shape of Training report dating January 2014 is available here (PDF).

The Society for Acute Medicine welcomes the Shape of Training report and supports the underlying principles of:

  • The move towards generalism recognizing that acute medicine has many specialists who focus on the generality of acute medical disease;
  • Greater flexibility, recognising for example the differing needs of separate specialties but at the same time focusing on the need for greater breadth of training to alleviate the significant pressure off the medical registrar role;
  • The emphasis on protecting the UK wide system of medical training;
  • The “apprentice” model for doctors and their trainers and the increased focus on mentoring that should be available for  all doctors as they progress in the early part of their senior career;
  • Extended rotations as have already been promoted within acute medicine training;
  • The delivery of training in both the community and hospital settings that will promote better understanding of the whole patient pathway;
  • Training being limited to places that provide high quality training and supervision.

These remain high-level objectives and the detail that will have to be determined to deliver these principles will be critical. In particular the impact of broader based thematic training programmes in acute medicine will have to be determined as will the need to ensure that sufficient skills and experience continues to be accrued by the end of core specialist training.

The assessment of progression will be crucial to ensure patient-centred care is truly effective and safe. We feel strongly that an aim to focus on CST to produce doctors with more generalist skills should not be interpreted as a way of creating a sub consultant grade.

The proposed pace of change is extremely challenging but even with that these changes do not address the problems of the patient with acute medical problems who develops such problems today. An emphasis on improving the contribution of senior and trainee physicians from across the specialties to the acute medical take could improve both training and service delivery.

Dr Mike Jones

SAM Education and Training Committee Chair

1 November 2013

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Cancer patients in crisis: responding to urgent needs

STRICTLY EMBARGOED – FOR RELEASE: 21/11/2012 00:01

Supportive Statement to the RCP’s Cancer patients in crisis report

The Society for Acute Medicine (SAM) urges healthcare professionals working in the acute settings to make use of the recommendations laid out by Royal College of Physicians in the report Cancer patients in crisis: responding to urgent needs.

Dr Chris Roseveare, SAM President said:  “The Society for Acute Medicine strongly supports this document which identifies many of the key challenges which may arise when patients with cancer become acutely unwell. This can be particularly problematic when a patient arrives on the acute medical unit outside regular working hours and when acute medical teams may struggle to obtain the necessary information about a patient’s treatment plan. The report highlights the importance of co-ordinated and multi-professional care in acute settings involving patients, carers, physicians, nurses and allied health professionals.

“A crisis may occur at any time and by emphasising the importance of clear documentation and regular review of the patient’s needs, this document will help to improve the planning and management of care for cancer patients”.

ENDS

Notes to the editors:

  • Acute medicine (also known as acute internal medicine) is the specialty which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the speciality of acute medicine and represents over a thousand members.
  • Dr Roseveare has been an acute medical consultant in a large teaching hospital since 1999.
  • The full document is available on the RCP website

Contact:

Claire Charras
Communications and Marketing Executive
Society for Acute Medicine
07 985 49 49 65
0117 983 0542
acutemedicinecomms@gmail.com
www.acutemedicine.org

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Dr Elizabeth Myers, nursing consultant, awarded honorary life fellowship by SAM.

For immediate release

Dr Elizabeth Myers, nursing consultant at NHS Tayside was awarded the Society for Acute Medicine’s (SAM) honorary life fellowship in Manchester on Thursday 11th of October at the SAM 6th International Conference.

It is the first time a member of the nursing staff is awarded an honorary life fellowship by SAM and demonstrates SAM’s commitment to the importance of the multi-professional team in acute medicine. Dr Myers was an executive council member of SAM from 2002 to 2011 and is a strong and powerful advocate for patients, nurses and allied health professionals. The fellowship is a recognition of her invaluable input and work with SAM.

Dr Elizabeth Myers said: “I am extremely honoured to receive this award and I hope it will encourage other nurses to take up leadership roles. It is only by working as a team that we will truly improve patient care”.

Dr Chris Roseveare, SAM President said: “I was delighted to be able to present this award to Elizabeth, on behalf of the Society for Acute Medicine, in recognition of the huge contribution which she made to the development of acute medicine over the past decade”.

Dr Myers remains passionately committed to promoting nursing in acute medicine and is proud to have been part of the growth of the specialty and to have had the opportunity to influence the multi-professional ethos of SAM.

ENDS

Note to editors:

  • Acute medicine (also known as acute internal medicine) is the specialty which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the speciality of acute medicine and represents around a thousand members.
  • Dr Myers trained as a general nurse at the Royal Infirmary of Edinburgh and undertook specialist training general intensive care at Guy’s Hospital in London. She has two research degrees and a PhD from Glasgow Caledonian University.
  • Dr Myers has been a nurse consultant for acute medicine in NHS Tayside since 2001.

 

Contact:

Claire Charras
Communications and Marketing Executive
Society for Acute Medicine
07 985 49 49 65
0117 983 0542
acutemedicinecomms@gmail.com
www.acutemedicine.org

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New toolkit to deliver increased consultant care to acutely ill medical patients

EMBARGOED UNTIL 00.01 HOURS THURSDAY 11 OCTOBER 2012

The fourth in the series of acute care toolkits from the Royal College of Physicians (RCP) has been produced in collaboration with the Society for Acute Medicine (SAM). The toolkit focuses on changes to the organisation of care, working practices and medical rotas to ensure a consultant physician is available to review acutely ill patients on the acute medical unit (AMU) 12 hours a day, seven days a week.

Acute medical illness is a seven day problem – patients are just as likely to develop an acute illness requiring an emergency admission on a Saturday or Sunday as on a weekday. Evidence that patients admitted at weekends have poorer outcomes than those admitted on weekdays,  and that patient mortality is higher at weekends led to the RCP and SAM recommending that a consultant physician dedicated to care of acutely ill patients should be available on site to review patients for at least 12 hours a day, every day*.

The toolkit provides practical guidance to senior hospital managers and clinical staff on how to organise acute medical services to ensure that the 12 hour consultant presence delivers consistent high quality care to acutely ill patients.

The guidance includes answers to key questions including:

  • How many consultants are required to provide a daily 12 hour presence on the AMU?
  • How many patients should a consultant be expected to review during their shift on the AMU and how long should this shift be?
  • How should consultant working and support services be organised in order to provide high quality patient care every day of the week?

Key recommendations are:

  • During the period of consultant presence on AMU, all newly admitted patients should be seen within a maximum of six to eight hours, with the provision for immediate consultant review for severely ill patients.
  • All patients in the AMU should be reviewed twice each day by the AMU consultant or the appropriate specialty team.  Most units will require more than one AMU consultant working each day to meet this requirement.
  • Consultant duties on the AMU should start no later than 8am and the consultant shift should usually be for between 8 and 12 hours.
  • When undertaking clinical duties on the AMU, the consultant should be free from any other specialty, ward or management commitments.
  • Individual consultants’ duties on the AMU should be for two or more consecutive days; any variation must be specifically designed to optimise the continuity of care provided to patients on the AMU.
  • Diagnostic and support services should be provided seven days per week, to ensure that the full benefits of consultant delivered-care to patients are realised.

Dr Mark Temple, RCP acute care fellow, said: “Consultant review of acutely ill patients 12 hours a day, seven days a week is key to the delivery of care that is of the highest quality on the acute medical unit (AMU). AMUs together with emergency departments are the busiest clinical areas in the hospital. This toolkit provides important new guidance on working practices during the consultant shift on the AMU and the number of patients a single consultant can be expected to review during this shift. Hospitals struggling to cope with increasing emergency admissions, can use the toolkit to reconfigure acute medical services and ensure that daily consultant review is integral to the provision of high quality care to patients with acute illness”.

Dr Chris Roseveare, president of the Society for Acute Medicine, said: “The presence of a consultant on the acute medical unit is essential to ensure high quality, safe, effective patient care; this toolkit is the first document which provides practical solutions to enable this to be achieved, for a minimum of 12 hours per day, seven days per week. Clinicians and managers now have the opportunity to calculate the workforce which they will require to deliver this, based on factors such as the size and configuration of the AMU, as well as the numbers of patients admitted on a daily basis. This is a landmark in acute medical care and represents a major step forward for the treatment of patients admitted to hospital in an emergency”.

Notes to Editors:

 

Linda Cuthbertson | Head of PR and public affairs
External Affairs | Royal College of Physicians
11 St Andrews Place | Regent’s Park | London NW1 4LE

Direct line +44 (0)20 3075 1254 | Mobile +44 (0)7748 777919
Email linda.cuthbertson@rcplondon.ac.uk| Fax +44 (0)20 7486 542

Claire Charras – Marketing and Communication Executive
Society for Acute Medicine
9 Queen Street, Edinburgh EH2 1QJ
Mobile: 07 985 494 965
Email: acutemedicinecomms@gmail.com

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Society for Acute Medicine Response to “Hospitals on the edge? The time for action”

Strictly embargoed – for release: 13/09/2012 00:01

“Patients face the prospect of a very long, tough winter” warns Society for Acute Medicine President, Dr Chris Roseveare

The Society for Acute Medicine (SAM) recognises the issues which have been highlighted in this report and supports the Royal College of Physicians’ call for urgent action to be taken.  SAM has been working to increase consultant presence on the front-line for over 10 years and strongly welcomes the drive for improved quality of care for acutely ill patients.

Dr Chris Roseveare, SAM President said: “Ensuring the delivery of high quality, safe and compassionate care for patients admitted to hospital in an emergency must be a key priority for clinicians, managers and politicians. There is increasing evidence that a consultant-led, multi-professional acute medicine team provides better outcomes for patients. It is vital that acute hospitals work to provide this consistently, seven days per week.

“The NHS is being asked to deliver huge financial savings at a time when many hospitals are already buckling under pressure from the rising number of emergency admissions. A co-ordinated approach is urgently required between hospitals, general practitioners and social care agencies to address the challenges which this report has identified; without this, patients face the prospect of a very long, tough winter”.

ENDS

Notes to the editors:

  • Acute medicine (also known as acute internal medicine) is the specialty which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the speciality of acute medicine and represents over a thousand members.
  • Dr Roseveare has been an acute medical consultant in a large teaching hospital since 1999.
  • The full document is available on the RCP website.

Contact:

Claire Charras
Communications and Marketing Executive
Society for Acute Medicine
07 985 49 49 65
0117 983 0542
acutemedicinecomms@gmail.com
www.acutemedicine.org

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Landmark Quality Standards launch on Acute Medicine Awareness Day to improve emergency care for hospital patients.

STRICTLY EMBARGOED – FOR RELEASE 20/06/2012 00.01AM

A landmark document designed to establish consistent standards of care for patients admitted to Acute Medical Units (AMUs) across the UK launches on 20th June. The document, ‘Quality Standards for Acute Medical Units’, is produced by the West Midlands Quality Review Service in association with the Society for Acute Medicine (SAM), and the launch is timed to coincide with the first ever Acute Medicine Awareness Day.

Dr Chris Roseveare, President of the Society for Acute Medicine says: “When a patient is admitted to hospital as an emergency it is crucial that the clinical team responds quickly to meet the patient’s needs. This document provides a major step towards ensuring that this vulnerable group of patients receives the highest quality of care in every part of the UK”.

The document also requires units to provide appropriate information to patients about their condition and the process of care on the Acute Medical Unit. Dr Roseveare adds: “Improving patients’ understanding of acute medical care is also a key aim of Acute Medicine Awareness Day; this will help to reduce the anxiety which many will feel during this difficult period”.

Quality Standards key recommendations for Acute Medical Units:

  • To ensure that a doctor experienced in the care of acutely unwell patients is immediately available at all times.
  • To provide a team of healthcare professionals, with the necessary skills to enable all aspects of acute medical care to be delivered on a daily basis
  • To maintain high quality, safe patient care at all times, with plans in place to deal with unexpected rises in patient numbers, when the capacity of the ward is stretched.
  • To ensure that patients are properly informed about their condition, the process of care on the unit and the services which can be provided to support them when they go home.

Lisa Carroll, consultant nurse in North Staffordshire and one of the authors of the document says: “The quality standards will ensure that patients being cared for in acute medicine receive high quality care wherever they present. They will help clinicians develop services and provide a framework on which they can benchmark themselves. This is an exciting development”.

Jane Eminson, Acting Director of the West Midlands Quality Review Service comments: “We have been pleased to collaborate with the Society for Acute Medicine on the publication of these Standards and hope this will bring the innovative work from the West Midlands to a wider audience”.

Professor Matthew Cooke, National Clinical Director Urgent and Emergency Care, says: “We know that earlier senior involvement in the emergency care of patients with acute medical problems improves their outcomes. Specialists in acute medicine are a key component in ensuring the best care for people who suffer sudden illness. This document supports this continuing improvement in care for these patients.”

Dr Mark Temple, acute care fellow, Royal College of Physicians London states: “The quality of care delivered on acute medical units is critical to the best outcomes for acutely ill patients. This important document sets out the quality standards for the care of patients with acute medical conditions, throughout the NHS”.

The document complements the simultaneous launch of The Silver Book, which deals specifically with the needs of older patients in the emergency setting.  Dr Roseveare says: “Releasing these two documents on Acute Medicine Awareness day emphasises the importance of delivering high quality care for patients of all ages when they first come in to hospital”.

ENDS

Notes to the editors:

  • Acute medicine (also known as acute internal medicine) is the specialty which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the speciality of acute medicine and represents over a thousand members.
  • The President of the Society for Acute Medicine, Dr Chris Roseveare, is available for interview.
  • Dr Roseveare has been an acute medical consultant in a large teaching hospital since 1999.
  • The full document will be accessible at www.acutemedicine.org.uk on 20th of June.
  • The Quality Standards in Acute Medical Units document complements the existing SAM Quality Indicators, launched in 2011, which are found on the website.
  • Pictures of the SAM logo and Dr Roseveare are available upon request.
  • Attached is a full list of the hospitals taking part in the first ever Acute Medicine Awareness Day.
  • The West Midlands Quality Review Service supports all NHS organisations in the West Midlands in improving the quality of health services.

Contact:

Claire Charras
Communications and Marketing Executive
Society for Acute Medicine
07 985 49 49 65
0117 983 0542
acutemedicinecomms@gmail.com
www.acutemedicine.org

Jane Eminson
Acting Director
West Midlands Quality Review Service
07788 413480
 

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Acute News Autumn Edition 2013

Acute News Autumn 2013 edition is here!

Acute News brings you the most up-to-date SAM and acute medicine news. This autumn 2013 edition includes an exclusive interview with Gemma Finnegan, social media expert on all things healthcare related; a preview of abcdeSIM, a new Dutch virtual learning tool for the acute setting and a summary of events for acute medicine awareness week.

Comments, feedback and suggestions for future newsletters are welcome and should be email to Claire Charras, communications@acutemedicine.org.uk.

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Hospitals across the country prepare to celebrate Acute Medicine Awareness Day on 20th June 2012.

Diary note: Society for Acute Medicine – forthcoming events and reports – 28th May 2012

There is now less than a month to go until the first ever Acute Medicine Awareness Day, organised by the Society for Acute Medicine (SAM).

Acute Medical Units (AMUs) from across the UK will be undertaking activities designed to raise public awareness of the benefits that growing specialty provides for patients admitted to hospital in an emergency. Many AMUs will also be organising events to raise money for their charitable funds to purchase medical equipment and other items to improve the ward environment for patients. Some of these events and activities are listed below.

In addition SAM is pleased to announce that the launch of two landmark documents will coincide with Acute Medicine Awareness Day. These two documents will have an enormous impact on the quality of care provided to patients admitted to hospital in an emergency. These documents are:

  • Quality Standards for Acute Medical Units :  Written by the West Midlands Quality Review Service in association with SAM, this is the first document to set out the standards of patient care in acute medicine which should be provided by AMUs across the UK. This document will be released on the 18th of June 2012
  • The Silver Book: This document addresses the specific needs of older patients who represent a large proportion of the workload for the AMU and acute medicine teams. It will be released on 20th of June 2012.

These landmark guidelines are designed to be used by healthcare professionals and emphasise a patient-centred approach to the care of people admitted to hospital in an emergency. Patients can feel vulnerable at this time, and need to be reassured that AMUs are operating to a consistently high standard across the UK.

Dr Chris Roseveare, SAM president says: “Acute medicine is an increasingly important specialty in the UK and has grown dramatically over the last decade; improving patients’ awareness of what to expect when they are admitted to hospital in an emergency will help to reduce the anxiety which many will feel during this difficult period”.

Examples of charitable activities being planned across the UK to coincide with Acute Medicine Awareness Day:

  • Dr Chris Roseveare, SAM President will be doing a Charity Skydive to raise money for the Acute Medicine Unit Charity Fund at University Hospital Southampton Foundation Trust.
  • The Heart of England, Goodhope Hospital in Coldfield will be holding a classical music concert, performed by one of the country’s leading chamber groups, the Galliard Ensemble.
  • The Royal Bournemouth Hospital will be using this opportunity to open its door of the recently open acute medical units.
  • Salisbury District Hospital is organising a charity summer ball and a raffle.

A further press release, containing more details of these events and copies of the two documents will be circulated on 18th June.

Further information about the events taking place on Awareness Day can also be found on the SAM website www.acutemedicine.org.uk.

ENDS

Notes to the editors:

  • Acute medicine (also known as acute internal medicine) is the specialty which provides the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine (SAM) is the national representative body for the speciality of acute medicine and represents over a thousand members.
  • The President of the Society for Acute Medicine, Dr Chris Roseveare, is available for interview.
  • Dr Roseveare is an acute medical consultant with extensive experience of working in acute medical unit.
  • Pictures of Acute Medicine Awareness Day activities, SAM logos will be available upon request.

Contact:

Claire Charras
Communications and Marketing Executive
Society for Acute Medicine
07 985 49 49 65
0117 983 0542
www.acutemedicine.org.uk
acutemedicinecomms@gmail.com

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Overwhelming majority of acute physicians do not support the health bill

For immediate release

A survey of members of the Society for Acute Medicine (SAM) has revealed that 94 per cent do not support the Health and Social Care Bill. Just under 50 per cent believe that the bill should be scrapped completely, while a similar proportion felt that SAM should work with the Royal College of Physicians to secure further significant changes to the legislation.

SAM President Dr Chris Roseveare says: “The results of this survey provide a clear indication of the concerns of clinicians working in acute medicine regarding the bill.

“Acute physicians see the challenges of providing emergency care on a daily basis. While many clearly recognise the need for reform, major structural reorganisation of the National Health Service at a time of such extreme financial pressure is not the answer. Greater competition between providers threatens to fragment urgent care; a more integrated service is required for the delivery of safe, effective treatment for patients who are acutely unwell.

“The fact that such an overwhelming majority of acute physicians do not support the bill in should send a clear message to the government. The views of this key group of health care professionals must not be ignored.”

Notes for editors:

  • Acute medicine (also known as acute internal medicine) is the speciality which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the speciality of acute medicine and represents over a thousand members.
  • The President (Dr Chris Roseveare) of the Society for Acute Medicine is available for interview.
  • Dr Roseveare is an acute medical consultant with extensive experience of working on acute medical units.
  • Our survey was distributed to over one thousand members of the Society and received 215 responses, the full results are available on the website.

Contact:

Sarah Hunter-Argyle
Communications and Marketing Executive
Society for Acute Medicine
07502 439 570

The Society for Acute Medicine
Administration Office
Society for Acute Medicine
9 Queen Street
Edinburgh

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‘Patients admitted to hospital deserve the same treatment at weekends as they would expect on a weekday’

For immediate release (28/11/11)

The annual hospital report published by Dr Foster has revealed that mortality for patients admitted to hospital at the weekends is 10 per cent higher than for those admitted on weekdays.

The reduction in the level of consultant cover at the weekend is likely to be a significant contributor to this higher mortality. The Society for Acute Medicine (SAM) strongly believes that a consultant should be present on the acute medical unit for at least 12 hours per day, 7 days per week. The attached policy statement has been developed to encourage our members to work with their employers to provide this.

Dr Chris Roseveare, President of The Society for Acute Medicine, says: ‘This latest report just adds to the mounting evidence that patients admitted over the weekend have higher mortality rates than those admitted on a weekday. The Society believes that patients deserve the same high quality consultant-led care irrespective of the day of the week on which they are admitted to hospital’

In some trusts seven day working could be achieved by adapting current rotas and job plans.

Dr Chris Roseveare: ‘This problem must be addressed now; patients’ lives are being put at risk. Investment will be needed to provide adequate numbers of consultants in some hospitals, but additional costs should be offset by greater efficiency, improved quality of care and shorter hospital stay for patients.’

ENDS

Notes for editors:

  • Acute medicine (also known as acute internal medicine) is the speciality which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the national representative body for the speciality of acute medicine and represents over a thousand members.
  • The President (Dr Chris Roseveare) of the Society for Acute Medicine is available for interview.
  • Dr Roseveare is an acute medical consultant with extensive experience of working on acute medical units.

Contact:

Sarah Hunter-Argyle
Communications and Marketing Executive
Society for Acute Medicine
07502 439 570

The Society for Acute Medicine
Administration Office
Society for Acute Medicine
9 Queen Street
Edinburgh
EH2 1JQ
www.acutemedicine.org.uk

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"August is always a nightmare": 90% of doctors believe national training changeover decreases patient safety

For immediate release

A new study has found that 90% of doctors who responded to a survey believe that patient safety throughout Scotland and the UK is compromised in August when the latest intake of medical trainee doctors start their training posts in the NHS on the same day nationally, and doctors already in training rotate into other positions.

Traditionally an estimated 50,000 doctors in the UK change over on the first Wednesday in August and there has been growing concern that this causes instability, poor safety and reduced patient care. In recent years, evidence has emerged to suggest that patients admitted at this time also have a higher early death rate than at other times.

In order to explore the impact of this changeover, the Royal College of Physicians of Edinburgh (RCPE) and the Society of Acute Medicine (SAM) conducted a survey of doctors’ experiences throughout Scotland and the UK, and this has just been published in the journal Clinical Medicine [1]. Key findings included –

  • 93% of respondents believed the August changeover has a negative impact on patient care
  • 90% of respondents believed the changeover has a negative impact on patient safety
  • 58% of respondents believed the changeover has a negative impact on doctors’ training

The negative effects on all aspects of care and training were found to last for up to one month.

A number of potential solutions were tested in the survey and over 80% of respondents believed that this situation could be greatly improved by moving away from the current national changeover on a single day to a staggered transition by grade, occurring over a period of over a month. Although not directly asked, the virtually unanimous view of comments submitted to the survey was that it would also be much more logical to move the changeover period to a different time of year in order to eliminate conflict with the holiday period.

Dr Louella Vaughan, Honorary Consultant Physician in Acute Medicine, and lead author of the study, said,

“The results of this survey add to the emerging evidence base which indicates that the current August changeover system increases a number of risks for patients, including an increased early death rate for patients admitted to hospital at this time.

“Over 90% of doctors who responded to the survey believe that patient safety is compromised every year in August by this outdated system. When considered along with other related evidence it is clear that the current system is in urgent need of reform. The doctors surveyed have indicated that not only is there an appetite for change, but the desire to enthusiastically lead and support it. All that is lacking now is the political will”.

Dr Neil Dewhurst, President of the Royal College of Physicians of Edinburgh, said,

“Patient safety and the quality of patient care are of paramount importance and should not be knowingly compromised. For many years doctors have been aware of practical problems caused by this annual changeover. Formal evidence in support of our concerns has, however, been limited, but is now increasing and has reached the level where it should not be ignored.

“Other changes to established systems within healthcare have been shown to deliver real improvements for patients and similar consideration must be given to making the changeover in training safer. We would urge the Scottish and UK governments to review this matter as a matter of urgency”.

Notes to Editors:

[1] Details of the survey can be accessed in the current issue of Clinical Medicine, Volume 11, Issue 4, August 2011.
http://www.ingentaconnect.com/content/rcop/cm/2011/00000011/00000004/art00006

[2] The snapshot survey was sent to 4384 members of the RCPE and SAM, and received 763 responses.

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Introducing Timely Discharge from Hospital, the new book from Liz Lees

For immediate release

‘It’s a massive topic that spans the whole health service. There is so much great work being done out there in the NHS, but generally people don’t write it up unless you give them a chance. And when you do it is absolutely inspirational.’

Liz Lees, 2011

Timely Discharge from Hospital is packed full of information, case examples and practical tips from a range of healthcare professionals from every nation in the UK. Their huge diversity of experience will appeal to staff from primary to secondary to community care, it will interest nurses, doctors, therapists, indeed, anyone involved in patient care.

Liz says: ‘It is a very practical book so it will appeal to operational staff. It is a vehicle to showcase and share pockets of excellence around the UK.’

While Liz’s first book was aimed at nurses this is very much a multi-disciplinary text, there are chapters written by doctors and nurses and perspectives from a pharmacist, an occupational therapist, a social worker and from the PALs team.

Liz believes discharge planning is vital to every clinical department in the NHS. She says: ‘Discharge planning is one of the most important aspects of policy facing the NHS today. Successful discharge planning can reduce length of stay, improve patient care and reduce readmissions, not to mention have a positive effect on a Trust’s budget.’

About 50 per cent of the book is dedicated to a range of case examples, stories that are told in the hope of advancing practical changes that will improve the patient experience. They range from a district nurse case focusing on the issues of communication and transfer problems to a case which features the safeguarding older of adults.

Liz says: ‘Each example is firmly grounded in a clinical practice offering vignettes and practical tips as situation based learning. They illuminate the reality of practice issues but attempt deal with them in a constructive way.’

Timely Discharge from Hospital will be published in October by M&K.

Notes for editors

  • Liz Lees is available for interview.
  • Photographs of the author are available.
  • Liz Lees is Consultant Nurse and Clinical Dean at Heartlands Hospital in Birmingham.
  • She has worked as a nurse for 23 years, and gained extensive experience in a range specialties including community setting and latterly for 9 years in acute medicine.
  • Liz has written three other publications on discharge planning, her first book Nurse Facilitated Discharge was published in 2007. She co-authored the Assisting Timely Discharge Multi-Professional Toolkit with the UK’s Department of Health and was on the national steering group for the Irish Discharge Standards (HSE).
  • She is the Nurse Representative for the Society for Acute Medicine.
  • The Society of Acute Medicine is the representative body for the specialty of acute medicine.

Contact:

Sarah Hunter-Argyle
Communications and Marketing Executive
Society for Acute Medicine
01896 870 317
sarahhunterargyle@hotmail.com

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Four Day Weekends

Four day weekends will throw NHS into disarray

The President of the Society for Acute Medicine (SAM) says that patient care could be severely compromised by the two consecutive four day weekends at the end of April. Several previous studies have shown that hospital death rates are higher for patients admitted outside normal working hours. During the eleven days from the 22nd April to 2nd May, there will be only three normal working days in numerous NHS trusts. Many hospitals have no plans to ensure that the care of patients admitted to hospital during this period is not compromised.

Dr Philip Dyer, President of the Society for Acute Medicine said: “It is essential that hospitals start to plan for this period; consecutive 4 day weekends will have a major impact on patient care. Hospitals already stretched by understaffing, as highlighted in the recent NHS Staff survey, will be under even greater strain during these days. Closure of GP surgeries and reduction of community services will add to this pressure.”

A survey, conducted by the Society and published on the SAM website today found that:

  • Over 50% of respondents indicated that their hospitals had not yet made specific plans to limit the impact of the holiday weekends.
  • The majority of acute physicians responding to the survey (86%) believe that   additional resources to support services such as radiology will be essential during the bank holidays; however only 5% indicated that their hospital was planning to provide this.
  • Most respondents to the survey (86%) would be prepared to work a ‘normal working day’ on the 29th April – however less than half indicated that their hospital was considering running such a service.

Responding to the results of the survey, Dr Dyer added:

“Hospitals need urgently to develop robust plans for this period involving the full range of services, in partnership with general practitioners and other community teams. Hospital Trusts and General Practitioners should aim to run a normal service on the 29th April to minimise the impact of this additional holiday on patient care.”

Notes for editors:

  • Acute medicine (also known as Acute Internal Medicine) is the speciality which deals with the immediate and early treatment of adult patients with a variety of medical conditions who present in hospital as emergencies.
  • The Society for Acute Medicine is the National representative body for the speciality of Acute Medicine.
  • The President (Dr Philip Dyer) and Vice President (Dr Chris Roseveare) of the Society for Acute Medicine are available for interview.
  • Dr Dyer and Dr Roseveare are both Acute Medical Consultants with extensive experience of working on Acute Medical Units.

Contact:
Sarah Hunter-Argyle
Communications and Marketing Executive
Society for Acute Medicine
07502 439 570
acutemedicinecomms@gmail.com
The Society for Acute Medicine

Administration Office
9 Queen Street
Edinburgh
EH2 1JQ

www.acutemedicine.org.uk
Twitter – @acutemedicine

To read the full survey report click here.

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As waiting times increase, death rates rise

The four hour target was scrapped last year and since then A&E waiting times have increased. A study carried out in Dublin, presented today at the Society for Acute Medicine Conference in Bristol, has confirmed that the longer patients have to wait for care, the more likely it is they will not survive.

At the same event, the Society for Acute Medicine (SAM) called for the full introduction of seven day working in acute units.

Increasing wait times

Data from over 20,000 acute medical patients collected between 2002 and 2008 shows an increase in mortality as wait time increases. The study used 30 day in-patient mortality as its outcome measure. There was an approximate threefold increase in mortality rate as wait time increased from less than 2.5 hours to greater than 9 hours. This happens at all levels of disease severity.

Researcher Dr Declan Byrne said: “This data adds credence to the position articulated by the Society for Acute Medicine that the 4-hour target has value in driving efficiencies and quality of care. In response [to the study results] we enhanced staffing levels at peak activity times to try and improve patient flow and reduce wait times.’

Dr Philip Dyer, President of the Society for Acute Medicine, has spoken against the scrapping of the four hour target. At the recent conference he said: “At this event we’ve noticed acute physicians are concerned about the increasing delays in A&Es over the last twelve months which are to the detriment of patient experience and potentially patient safety. We’re keen to work with other groups to reverse this trend.”

The necessity of seven day working

Evidence presented – drawn from several studies – showed that seven day working lowers morbidity and mortality rates, improves patient experience, lowers length of stay and reduces rates of hospital acquired infections.  However the measures have only been patchily implemented in the NHS.

Professor of Acute Medicine at Imperial College London,  Derek Bell, stressed that if seven day working is not implemented that: “At a fairly important time in acute medicine in the UK, I think we are in grave danger of turning the clock back 10-15 years.”

Seven day working could require double the number of available consultants that are currently working, however, the associated efficiency savings could off-set a large part of those costs, and the health benefits could be vast.

President of the Society for Acute Medicine, Dr Philip Dyer, said: “We know that demand doesn’t fall significantly over weekends, and evidence shows that patients are more vulnerable during the evenings and weekends, hence the need for better out-of-hours cover.”

ENDS

Notes for editors:

• The Society for Acute Medicine Spring Meeting runs from 5th-6th May in Bristol.
• Dr Derek Bell spoke on Thursday 5th May; Dr Declan Byrne spoke on Friday 6th May.
• Dr Declan Byrne is a Consultant Physician in the HSE South at Kerry General Hospital.
• The research was carried out in St James’s Hospital, Dublin and the head of research group was Dr Bernard Silke – Director of the Acute Medical Admissions Unit.
• The Society for Acute Medicine is the National representative body for the speciality of Acute Medicine.

Contact:
Sarah Hunter-Argyle
Communications and Marketing Executive
Society for Acute Medicine
07502 439 570
acutemedicinecomms@gmail.com

The Society of Acute Medicine

Administration Office
9 Queen Street
Edinburgh
EH2 1JQ

www.acutemedicine.org.uk

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