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'A Fantastic Event'

Acute Medicine: Making it Safer, Doing it Better: the 5th International Conference of the Society for Acute Medicine, Imperial College, London, 29-30th September 2011

Six hundred acute medicine professionals descended on an unseasonally hot and humid London to attend the 5th international SAM conference. Delegates from around the UK were joined by a large number from further afield, including Australia, New Zealand and the USA. The European contingent included a particularly large group from the Netherlands where acute medicine is rapidly developing.

Delegates were welcomed to Imperial College by Professor Derek Bell, the inaugural President of the Society and a key local member of the conference organising committee. He opened the initial Plenary session, ‘The Political Landscape and Acute Medical Care’ with some reflections on the importance of ensuring that acute medicine adapts meet the challenges of the changing NHS. Alan Dobson from the Royal College of Nursing and Professor Sir Peter Rubin, President of the General Medical Council continued this theme; Professor Rubin summarised the timetable for revalidation, indicating the influence of the Bristol enquiry into Paediatric surgery in driving forward this change. During questions, delegates pressed him on the time required to undertake robust data collection and appraisal – he re-iterated the needs for hospital Trusts to ensure that time is allocated during job planning.

The session ended with the presentation of the Third SAM Honorary Fellowship to Major General George Cowan, who was instrumental in ensuring speciality recognition for Acyte Medicine. After receiving the award from outgoing SAM President, Phil Dyer, he summarised his ‘Experiences in Acute Medicine’ with a series of entertaining anecdotes collected during his working life in the British army.

This year featured a particularly strong parallel programme for nurses and Allied Healthcare Professionals which ran through both days of the conference. Chaired by Alan Dobson, the sessions reflected the overall theme of the conference of quality and safety, underlined by the title ‘Acute Medicine: Making it Safer, Doing it Better’. The conference organisers were pleased by the healthy multiprofessional attendance at the meeting, particularly given the difficulties which non-medical staff have had recently in obtaining funding to attend. However clearly more needs to be done to encourage an even larger attendance in future years, and SAM will be working with the nursing and AHP representatives on Council to identify ways in which we can help Units to raise funds for this.

One of the key highlights of the international SAM conferences is the opportunity to hear acclaimed International speakers. This year’s meeting did not disappoint in this respect. On day one, Professor Salvatore di Somma from Rome and Professor Frank Peacock from the USA described how biomarkers can be used in risk stratification; many delegates were able to identify with the challenges of improving safety in discharge, particularly when there is pressure to make decisions soon after the patient has arrived. In the same session Tobias Breidhardt from Basel in Switzerland described some key technological advances in the management of the cardiorenal syndrome which are the subject of his current research with the University of Nottingham. SAM was delighted also to welcome back Professor Victor Tapson, who had previously spoken at the 1st International meeting in 2007. On that occasion his subject was pulmonary embolism; this time he focussed on the recognition and early treatment of pulmonary arterial hypertension, a rare but important differential diagnosis to consider for the patient with unexplained breathlessness.

Once again one of the most popular and diverse sessions was the Oral Poster Presentations. ‘It’s always my favourite session,’ said Dr Philip Dyer, chairing the parallel session on the second morning of the conference. ‘The standard over the years has just gotten higher and higher and it is always exciting to see what our members are doing in their units to improve acute care’. Over 100 posters were selected for display from more then 250 abstract submissions, and a number of these were awarded ‘highly commended’ rosettes by a judging panel.

John Heyworth, past President of the College of Emergency Medicine, chaired the opening plenary session of day two entitled ‘Acute medicine and emergency medicine: the interface’. His opening remarks stressed the importance of ensuring that acute care remains at the top of the health care agenda. He described the ‘Axis of Access’ as being key to maintaining patient flow through AMUs and Emergency Departments, identifying the importance of close collaboration between these two specialities over coming years. ‘It’s time for those in positions of power and influence to recognise the importance of acute and emergency care’, he said, while emphasising the need to take action quickly to ensure that we have influence in clinical commissioning groups. Clinical challenges which may present either to emergency or acute physicians were the theme of the remainder of this session. The clinical theme continued with ‘New Perspectives on Old Problems’ – Professor Brian Gazzard challenged delegates to consider HIV testing for most – if not all – all acute admissions and former RCP President Sir Ian Gilmore presented the frightening rise in the incidence alcoholic hepatitis particularly among younger patients: clearly a problem that acute physicians will face increasingly in their practice over coming years.

In the final plenary session, ‘Acute Medicine: Better and Safer’, inspiring talks from both sides of the Atlantic provided delegates with food for thought as they conference drew to a close. Professor Bob Wachter, considered the ‘father’ of the Hospitalist movement in the USA, described the dramatic expansion of this speciality which now boasts 30,000 members. ‘Acute medicine is not as far advanced as it should be with regards to patient safety,’ he said, calling on acute physicians in the UK to follow the lead of Hospitalists in placing patient safety.

The meeting saw Phil Dyer pass the Presidential baton to Chris Roseveare, who now starts his two year term. Chris has been involved with SAM since the beginning and was one of the original five committee members in 1999; however in closing the conference he stressed the need now to look forward to greater involvement from the next generation of acute physicians. ‘Ten years from now the SAM council will look very different to how it looks today’. He said, ‘It is essential that the new breed of trained acute physicians steps up to the plate and carries the specialty through to the next decade and beyond’. Chris thanked delegates for attending and we look forward to seeing as many of you as possible at our 25th SAM conference in Dublin next Spring.

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