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Acute medical units ‘never more important’ to NHS

A leading doctor has said acute medical units (AMUs) have never been more important to the future of the NHS as winter starts to bite.

Dr Mark Holland, president of the Society for Acute Medicine (SAM), said the departments played a “critical” role in maintaining quality for patients during “unprecedented” pressure last winter.

He spoke out ahead of Acute Medicine Awareness Day, which takes place tomorrow (Thursday) and will see staff in AMUs across the country undertake activities and provide information for patients and visitors to improve understanding of the specialty.

Acute medicine, also known as acute internal medicine, deals with the immediate and early treatment of adult patients with a variety of medical conditions who present to hospital as emergencies.

The specialty receives the majority of patients admitted from A&E and plays a vital role in maintaining the flow of patients through emergency departments to avoid exit block, the term used when patients cannot be moved into a hospital bed.

“Our staff performed tremendously well during a very difficult winter last year and, with pressure on the system set to intensify this year, our awareness day is an opportunity to highlight the importance of acute medicine and the role it plays,” Dr Holland explained.

“Teams at hospitals across the UK will be taking the opportunity to talk to patients, visitors and colleagues about the work they do and why acute medicine is a vital cog in the NHS system during the most intense periods.”

Dr Holland, a geriatrician by training, said the awareness day would also be an opportunity to talk about some of the key issues facing hospitals – particularly care for elderly patients.

Providing the right care for older people at the time of admission to hospital through a multidisciplinary team, known as comprehensive geriatric assessment, ensures older people have a better chance of early discharge and a reduced risk of early readmission.

“Patients and members of the public hear a variety of problems affecting the health service on a weekly – sometimes daily – basis, so we believe it is very important to engage them with the key issues which impact people’s hospital experiences,” he explained.

“Last year, bed capacity issues caused by delayed discharges stretched the system to breaking point, yet it remains unresolved, with around 30% of hospital beds currently taken up by patients who don’t need to be in them.”

He added: “We need to make sure that hospitals and social care services are joined up to provide patients with the care they really need, while action must be taken to improve social care funding.

“If not, many patients who are ready to be discharged will remain in hospital unnecessarily, causing a lack of beds for patients being admitted and that will eventually grind services to a halt.”

Dr Nick Scriven, SAM’s vice-president, said: “In light of the many other difficulties facing us at the moment – increasing numbers of acutely unwell patients, a growing elderly population, recruitment issues and a dispute between junior doctors and the government – acute internal medicine stands to play a pivotal role this winter in supporting the NHS.

“We will do so by providing solutions to the challenges we face and, more than ever, by providing the best care possible for patients which, at the end of the day, is all we really want to do.”

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