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Society for Acute Medicine Benchmarking Audit (SAMBA) – notice of tender

Society for Acute Medicine Benchmarking Audit (SAMBA) – notice of tender

 Notice of tender for a contract with the Society for Acute Medicine (SAM) to provide an online portal for secure data collection, data analysis and short term storage pending secure data transfer (for subsequent long term storage within existing SAM facilities). 

Please click here to download the full call for tenders.

Call opens: 11.3.19

Call closes: 8.4.19 – Bid to be emailed to administrator@acutemedicine.org.uk by 17:00

 

Further enquires to

Professor Dan Lasserson, SAMBA Lead

D.S.Lasserson@bham.ac.uk

 

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SAMBA18 National Report

SAMBA18 National Report

We are pleased to inform you that the SAMBA18 National Report is now available here.

SAMBA18 National Report

We hope that the report will be of use.  We have included the names of participants who were made known to us.  We would be happy to amend the names of participants if there are any errors and if so we apologise in advance; let us know if we can help.

As one round of SAMBA finishes, another begins.  Please get ready for Thursday 27 June 2019.  Over half of all UK AMUs now participate in this annual event and we look forward to more people joining us this year.

We also look forward to your comments and hope you can join us at the SAMBA sessions at our next two conferences, SAM-on-the-Tyne (May 2-3 2019, Gateshead) and SAM-on-the-Moor (October 10-11 2019, Harrogate).

For now, we hope you enjoy reading the report and once again thank everyone who contributed to the audit, which was recently quoted in the NHS Long-Term Plan.

Professor Dan Lasserson, SAMBA Lead

Professor Mark Holland, Past President to the Society for Acute Medicine

On behalf of the SAMBA Academy

 

The SAMBA18 Interim Conference Report can be found here.

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Figures show an NHS under “severe strain” – SAM president

Following the release of NHS performance data for January, Dr Nick Scriven, president of the Society for Acute Medicine, said:

“Although there is less minor illness associated with flu this year, there are more severely ill people than last year which is putting an even bigger strain on the critical care facilities in our hospitals.

“From the weekly situation reports, adult intensive care unit occupancy is higher this year than last for the same week (85.6% v 85%), with 21 ICUs declaring 100% full even on the best day which is same as last year.

“This figure is extremely concerning as it implies that there is no more capacity in the system than last year for the very sickest people with many units full, leading to either delays in treatment or vulnerable patients needing transportation to hospitals perhaps many miles away to find the care they need.

“At the other end of the scale it is worth noting for comparable weeks that ambulance delays seem higher than last year together with virtually identical occupancy rates for general beds and, if anything, slightly higher number of beds closed due to infection.

“With the Royal College of Emergency Medicine figures showing even worse performance against the four-hour target, these figures point to a service under equally severe strain as last winter and actually paints a very different picture to the ‘mood music’ coming out weekly from the NHS.

“Any NHS worker will tell you that the stresses and strains are very real and ongoing with no let up in sight.

“Perhaps the lack of public discussion about the pressures facing us this winter reflect the reality that frontline staff grimly accept that things are tough and have no energy leftover to get agitated in the face of no real improvements over recent years of struggle.”

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Senior medic says upbeat NHS winter messages “hiding true picture”

Dr Nick Scriven, president of the Society for Acute Medicine.

I think it is fair to say that those within the Department of Health and Social Care are the only people who are happy with the whole Brexit debacle in that it has firmly deviated all attention away from the current state of the NHS.

I note with some amusement the positive spin put out every week by NHS England regarding the weekly situation reports – ‘SitReps’ – and how they claim, for example, a bed occupancy of 0.1% less than this week last year is good.

At the same time, attendances at emergency departments are higher than last year and they seem to refuse to acknowledge the effect of having nearly 2,000 beds closed at present due to norovirus and flu.

They are also seemingly oblivious to the Royal College of Emergency Medicine winter flow metrics, produced weekly, that show performance against the four-hour target in their measured trusts is the poorest ever.

The RCEM quotes “At 77.92%, performance is 3.11 percentage points lower than was the case in 2017-18 and in is, in fact, the lowest performance figure we have ever recorded in the fourth week of January” – despite a bed base that is currently up more than 3% since the beginning of winter.

My take on the SitRep data is that to try to maintain a service we have worked harder than ever in a period of concerted and continual high pressure and, worryingly, this is increasing bit-by-bit as staff tire.

We are starting to see stories in the press around pressure points, most recently the delays in ambulances coming to people’s aid. I fear these are the high profile tips of the iceberg of stress and strain on our NHS.

The relentless upbeat messages from central NHS are hiding the true picture and we again find ourselves saying that comparisons to the ‘crisis’ last year are invalid.

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Strain on hospitals ‘increasing week-on-week’ says SAM president

Following the release of the latest weekly winter performance data across the NHS, Dr Nick Scriven, president of the Society for Acute Medicine, said:

“The strain on hospitals is increasing week-on-week, with cases of influenza rising and now the added pressure of the first real cold spell this winter.

“In the meantime, as has been the case for some time now, parliament is distracted by infighting and political point scoring, ignoring their collective responsibility to the public.

“So far, mild weather has helped to ensure the focus stays off of the NHS but, behind the scenes, many hospitals are gridlocked with large numbers of extremely unwell elderly people and that will only worsen in the coming weeks.”

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Senior medic “staggered” by omission of acute and emergency care in NHS plan preview

Following the release today of key features of the NHS ten-year plan ahead of its publication tomorrow (Monday), Dr Nick Scriven, president of the Society for Acute Medicine, said:

“While any plans to improve services across the NHS are always welcome, I am staggered that the key priorities released a day early by the Prime Minister overlooked acute and emergency care and hospital capacity.

“What is particularly ironic is that the government and NHS leaders have chosen to preview a ten-year plan omitting this area on the weekend traditionally the most difficult on the frontline.

“The full plan to be released tomorrow will come on the day many health systems will be on black alert – the highest level of pressure on hospitals – so here’s hoping all will change.

“The reason being, having already delayed this plan from the summer until now, there has – so far – been minimal focus on the scale of the near-on impossible task hospitals face in managing increasing demand while faced with decreasing capacity, funding issues and a recruitment crisis.

“The harsh reality right now is that the NHS is at least 3,100 beds short of what it required last winter, more than 45% of consultant posts are unfilled along with 11.6% of nursing posts and the proposed green paper on social care is nowhere to be seen.

“Today’s lack of acknowledgement of how we effectively tackle the eternal winter in the NHS and its associated problems is indicative of how acute and emergency care is the poor relation when it comes to priorities.

“We await further details of the plan tomorrow to discover if there is better focus, though the promised workforce report and social care green paper will be integral to determining if a sustainable future can ever be reached and that won’t happen for some time.”

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Senior medic says he is “expecting severe difficulties” in NHS this weekend

A senior medic says he is “expecting severe difficulties” this weekend as the cold snap sets in and adds further stress to stretched NHS services.

Dr Nick Scriven, president of the Society for Acute Medicine, said hospitals saw “fits and spells of manic activity” last week.

He said the number of cases of viral chest illness was growing and the outlook was “ominous” with colder temperatures now setting in.

Official figures from the week ending 23 December confirmed the rise to ‘moderate’ and highlighted the shortfall in vaccinations, with only 43.4% of those at risk under the age of 65 having had the vaccine.

“Influenza is here and is already impacting the NHS and, with colder weather starting to set in, this will further stress already stretched services,” he said.

“I and many colleagues across the country are anticipating mayhem this weekend as temperatures drop – but it will come as no surprise to us.

“There was a sense before Christmas that government and NHS leaders believed all was well despite only marginal performance differences to the crisis of 12 months ago.

“My feeling is that this was more out of hope than judgement and, sadly, the issues we have predicted for some time will soon take hold.

“Within the last week I have had colleagues warning of emergency departments and intensive care units being full and that will only worsen in the coming weeks.”

Dr Scriven said “skeleton staffing” in social care over the festive and New Year period meant many hospitals would be working flat out to clear patient discharges until the weekend that may have been on hold since Friday, 21 December.

“The issue around delays in social care arrangements over the festive period has always been an issue but, in light of added pressures in the NHS – staffing, demand, colder weather – the capacity problems this will cause could be profound.

“Most significantly, however, and most worryingly, is that the NHS is horrendously understaffed – more than 45% of consultant posts are unfilled, along with 11.6% of nursing posts.

“This will ultimately have a major impact on the ability of hospitals to cope.”

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NHS data shows “massive stress” on system – SAM president

Following the release today of weekly NHS winter performance data, Dr Nick Scriven, president of the Society for Acute Medicine, said: “As we approach the holiday season the pressure on the frontline of healthcare is ever-increasing.

“Figures show a continued week-on-week decline in emergency department performance against the four-hour target with delays across the system.

“We can see in today’s data there is massive stress on the system with overall bed occupancy at 94.5% and nine hospitals showing more than 99% full even on their best days.

“Additionally, these figures don’t show the whole picture as they are “massaged” by including specialist centres, such as children only, which always run at 70%.

“Unfortunately calls from SAM and others have not been heeded and we see a health service staggering into winter with a parliament that has been paralysed for months – if not years – by Brexit debates and party-political agendas.

“If there is a silver lining at present, it is that there is so far no major indication of a more than ‘usual’ amount of influenza or norovirus but, with ward overcrowding, the latter is going to be inevitable at some point.

“As is now the norm, it will require a near superhuman effort to try to keep the system safe for all our patients and maintain dignity and it is simply not fair on hard-pressed staff to subject them to relentless pressure year-on-year while failing to take appropriate action to meet demand.”

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Senior medic warns of ‘significant problem’ ahead of winter

Following the release of the latest NHS performance data, Dr Nick Scriven, president of the Society for Acute Medicine, said: “Performance against A&E targets are among the worst on record, emergency admissions have risen and the number of cancelled operations has risen.

“Add this to the fact we are going into winter in exactly the same state as last year with high bed occupancy rates – more than 15,000 patients in hospital for more than 21 days and more than 2,500 extra beds already in use – we have a significant problem.

“After decades of bed reductions there are simply not enough appropriately staffed beds available to meet the current demand and this has many serious knock-on effects for patients.

“We have consistently raised this issue publicly for more than 18 months and highlighted it is now common both in summer as well as winter.

“So far, the Department of Health and Social Care has seemed unwilling to engage with us to try to formulate a plan but we clearly need urgent action to address the risk to acute and elective care.

“We would again put a call out to the health secretary to ask him to meet with us so we can all understand the issues collectively and try to work together for the good of our patients.

“We are heading into yet another winter season without much of a plan beyond influenza vaccinations and a promise of finance that may not actually reach the areas it would be designed to help in a useful time-frame.”

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Excess winter deaths report highlights pressures on the NHS

Following a report released today by the Office for National Statistics which shows there were more than 50,000 excess deaths in England and Wales over winter in 2017/18,
Dr Nick Scriven, president of the Society for Acute Medicine, said:

“This is an extremely large increase in the number of deaths over the winter period and raises concerns with regards to the persistent winter problems we are encountering across the NHS on an annual basis now.

“In 2016, we coined the phrase ‘eternal winter’ as a result of sustained pressure throughout the year which, by the time winter actually hits, leaves hospitals struggling to cope having been maxed out all year round.

“We have an older, frailer population with increasingly complex medical problems, a lack of funding across health and social care to meet demand, a recruitment crisis and persistently poor performance.

“Although the influenza outbreak did cause deaths, it cannot be the single factor to explain this figure of more than 50,000 and a rise of approximately 15,000 compared to the year before.

“Ultimately, despite reassurances from the government and NHS leaders that enough funding has been made available and the service is coping with the additional demands placed on it, the reality is clearly different given these statistics.”

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Leading medic says NHS improvement report ‘very concerning’

Following the release today of NHS performance data for July to September by NHS Improvement, Dr Nick Scriven, president of the Society for Acute Medicine, said:

“Today’s report from NHS Improvement and their projected recovery date is very concerning.

“The Society for Acute Medicine has been warning for some time now that pressure in the system has left no room for any extra winter “pressure”.

“There has been a relentless rise in emergency admissions without any significant changes to resource for those looking after these people, which includes no change in bed numbers or staff, both nursing and medical.

“The worry we have is that we appear to again be “sleepwalking into winter” without any real plan on how we cope and a secretary of state distracted both by political issues (Brexit) and his desire to work with IT dreams rather than the pressing needs in our hospitals and communities.

“We yet again ask those responsible to work with us and the medical royal colleges to try to find a way of helping us to care for poorly people over the next months as well as looking after the service’s major resource, its staff.”

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Same-day emergency clinics could save NHS 14,000 extra beds

Senior medics have warned the NHS is “on borrowed time” as winter approaches – but say better use of same-day emergency clinics could save at least 14,000 overnight hospital stays.

In a report released today, Winter 2018/19 in the NHS: The solutions, the Society for Acute Medicine (SAM) calls on the government and NHS leaders to “realise urgently” the potential of ambulatory emergency care (AEC).

The service, which sits within acute medical units, offers an alternative to hospital admission for patients with serious medical problems who might otherwise have spent at least one night in a hospital bed.

There are around 20 conditions, such as life-threatening blood clots (deep vein thrombosis), dislodged blood clots (pulmonary embolism), cellulitis, seizures and anaemia, suitable for treatment in this outpatient-based setting.

In a recent audit, which covered 127 acute medical units and 6,114 patients over a 24-hour period in June, SAM found only 20.1% of patients received their first assessment in AEC and, of these, 79.5% returned home the same day – saving 977 overnight bed stays.

SAM president Dr Nick Scriven said that just a 5% increase in the number of patients who receive their first assessment and subsequent treatment in AEC could save an additional 238 overnight bed stays – which would equate to 14,042 overnight admissions over January and February.

“AEC has obvious benefits for the patient in that they usually remain in their own clothes, remain mobile and get to sleep in their own beds while, for the hospitals, it is a way of alleviating overnight bed pressures,” he said.

“Given how much pressure we are all under, it would seem reasonable to look at how much could be achieved with investment in this area.

“From our projections, just a 5% increase in the number of emergency patients being seen in AEC could save at least 14,000 overnight beds days across the busiest winter months.”

In September, SAM warned the additional 900 beds the Department of Health and Social Care’s additional £145 million investment this would cover falls 3,100 short of the number required last winter.

Dr Scriven urged the government to look at “how much could be achieved with investment in this area” and address why the implementation of AEC units was “not standard or uniform” across the country.

“With winter rapidly approaching the NHS is on borrowed time. AEC would seem to be an area that is beneficial to both patients and the service but is variably used throughout the country,” he said.

“To evoke maximum benefit, a significant investment and national plan for this area is required.

“In the interim, we believe the government and NHS leaders should realise urgently the potential of AEC to have a transformative effect on bed capacity and develop a broad based guidance to help advise hospital trusts on utilising AEC as efficiently as possible.”

View Winter 18-19 in the NHS – The solutions. 

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SAMontheTYNE – 2-3 May 2019

SAMontheTYNE – 2-3 May 2019

Welcome to SAMontheTYNE, being held on the 2-3 May 2019 at the Hilton Newcastle Gateshead Hotel

The conference is aimed at the whole multidisciplinary team who work day in, day out, in acute and general medicine.

SAM conferences are rated highly for their friendly, welcoming atmosphere and this is your opportunity to Learn, Network and Enjoy spending time with colleagues who face the same challenges as you.

12 CPD Points have been applied for.

View the Programme 

Registration now open!

To register, please click here.

Abstract submission

Abstract submission is open until 3 March 2019.

For more information, view the Call for Abstracts.

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BMA winter analysis: A welcome evaluation but hides the true misery – SAM president

Dr Nick Scriven, president of the Society of Acute Medicine said: “Like our colleagues in emergency medicine, we welcome the review of the NHS emergency care data by the BMA.

“This confirms what we both have been saying now for some time and shows with clarity the effect that the massive reduction in inpatient bed capacity, along with increasing demand year-on-year has had on our ability to care for acutely unwell people who come to our hospitals relying on the NHS for safe, effective and compassionate care.

“The truly worrying aspect is the decline is happening right through the year without respite and bares out the assertion we made last year that the NHS is in an ‘eternal winter’.

However, everyone should look beyond the figures at what this means for patients. Not only is it long hours spent waiting to be seen in emergency departments but then, if admission to the wards is needed, there can be further delays in conditions so far from ideal they should not be allowed to happen (for example, patients waiting on trolleys in corridors).

“Unfortunately the conditions may not improve in the hard-pressed admission units and wards beyond them who often struggle on sub-optimal staffing levels with extra patients ‘boarded out’ to try to ease pressure on the emergency department.

“Again, like our colleagues, we acknowledge the extra funding but worry it is much less than the amount needed last year to bail out the system and has left little time for it to make a material difference in our communities or our front line hospitals.

“We would again ask the leaders of the NHS and the Secretary of State who is approaching his first winter in charge of the NHS to urgently seek the advice of those working day-after-day on the front line on measures that might help now and over the next three months which must be our current overriding priority.”

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SAMBournemouth Presentations

We have received permission to share the following presentations from the conference. Click on the links below to view.

Thursday 20 September

PLENARY 1: BIG ISSUES, BIG ANSWERS IN ACUTE MEDICINE  

SAM Fellowship Award, Reflections on 21 Years in Acute Medicine, Dr Tanzeem Raza OBE

SESSION 2.1: QUALITY IN ACUTE CARE

Getting It Right First Time in the AMU, Dr Nick Scriven

Growth of Hospital Medicine in the USA & Worldwide, Dr Ron Greeno

NICE Guidelines: Their Role in the AMU, Prof Dan Lasserson

SESSION 2.2: GOOD PROFESSIONAL HEALTH

Human Factors & Lessons from the Aviation Industry, Captain Chris Guy

Schwartz Ward Rounds, Kate Horsefield

Recognising Burnout & Resilience in the AMU, Andrew Kinder

SESSION 2.3: NURSES/AHPS/PHARMACISTS IN AIM – AMBULATORY CARE 

AHP Led Ambulatory Care, Julia Nixon

The Role of the Pharmacist in Ambulatory Care, Runa Patel Kumar

Ambulatory Emergency Care, Dr Sunil Lobo

SESSION 3: YEAR IN REVIEW: REFLECTIONS THEN, REFLECTIONS NOW

Is Reflection Dead? Professor Derek Bell OBE

SESSION 3.1: ACUTE ONCOLOGY

What’s New in Acute Oncology? Dr Ernie Marshall

The UKONS Tool & Triage in Acute Oncology, Philippa Jones

Immune-Mediated Toxicities: Coming Soon to an AMU Near You, Dr Tim Cooksley

SESSION 3.2: MODELS OF ACUTE CARE: WHAT DOES GOOD LOOK LIKE? A GLOBAL VIEW

The USA Model, Dr Ron Greeno

The Spanish Model, Dr Eva Baro

The Dutch Model, Prof Prabath Nanayakkara

SESSION 3.3: Oral Presentations 1

SESSION 4: THE ACUTE CONSULT: PROBLEMS IN MY PRACTICE

Does My Patient Need a Blood Transfusion? Dr Edwin Massey

Red Eye – What Does the Acute Physician Need to Know? Dr Catherine Marsh

SESSION 4.1: FRAILTY IN THE AMU

Delirium, Dr Dearbhail Lewis

Collapse in the Older Patient, Dr Lara Mitchell

Polypharmacy – What to Start & What to Stop, Dr Martin Wilson

SESSION 4.2: MODELS OF ACUTE CARE: WHAT DOES GOOD LOOK LIKE? A UK VIEW

In Scotland, Dr Duncan Scott

In Wales, Dr Chris Hodcroft

In Northern Ireland, Dr Ian Wallace

In Wolverhampton, Dr Lee Dowson

In Surrey, Dr Ben Mearns

SESSION 4.3: Oral Presentations 2

 

Friday 21 September

SESSION 5: MANAGING THE ACUTELY UNWELL PREGNANT PATIENT

Clinical Conundrums in Maternal Medicine, Dr Francesca Neuberger

SESSION 5.1: MOVING CARE FORWARD

National Dashboards: Can it Improve Patient Flow? Samantha Riley

Collecting Data on the AMU: Can we Collect it Better? The Emergency Care Minimal Dataset, Dr Tom Hughes

Quality Improvement: The RCP Perspective, Dr John Dean

SESSION 5.2: TRAINEES IN AIM

Reflections From Europe: Lessons Learned from the ESIM Winter School, Dr Mark Lander

My Experience of Working on SAM Council, Dr Tehmeena Khan

My Experiences as an RCP Education Fellow, Dr Shuaib Quraishi

SESSION 5.3: NURSES/AHPs/PHARMACISTS IN AIM, DEVELOPMENTS IN ROLES, COMPETENCIES & RESPONSIBLITIES

PAs as Part of the MDT, Sarah Vigor & Dr Natalie King

Masters Module in Acute Medicine, Dian Huyton

Supported Discharge – Physios & OTs, Stephanie Robinson

SESSION 6: FLY TIPPING ON THE AMU (NON-MEDICAL PROBLEMS ON AMU)

Fly tipping – negotiating with…ologists, Dr Darren Green

Polytrauma on AMU, Dr Mark Baxter

SESSION 6.2: RESEARCH IN ACUTE MEDICINE

NIHR Research Design Service, Prof Gordon Taylor

Working with NEWS in the Community, Dr Alison Tavare

SESSION 6.3: Wee Shorty’s: Improving Service Organisation & Design in the AMU

SESSION 7: BIG ISSUES, BIG ANSWERS IN ACUTE MEDICINE

Models of Acute Care, Professor Nigel Edwards

Medicine is Brilliant, Andrew Goddard

The Last Word, Dr Nick Scriven

 

 

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Research Fellow in Acute Medicine – Clinical & Research – Sandwell and West Birmingham Hospitals

Research Fellow in Acute Medicine – Clinical & Research

“Right now we are building our future”

We are seeking to recruit an enthusiastic and hardworking doctor to join our Acute  Medicine Department. This is a 50% clinical, 50% research-based  role and the successful candidate will gain research experience and specific research training in Acute Medicine to further the academic development of this specialty.

50% will be spent in research, developing specific research skills as part of an individually specified programme, developing a research project and delivering that project with the support and expertise of the Acute Medical research team.   The candidates will be taught the needed research skills including dataset management and data analysis.  It is expected that the successful candidate will work towards a Masters degree with the potential to progress to an MD or PhD, depending on progress.  You will work under supervision of Dr S Clare (Clinical Lead Acute Medicine ) and Prof Dan Lasserson ( Professor Of Ambulatory Care).

This post will be a one year fixed term post in the first instance starting from as soon as possible with the possibility of longer term opportunities within the Trust subject to performance and progress. These post would be aimed at ST3/4 level for specialty middle grade posts (ie 3/4 years post qualification/post foundation level).

We will mirror the training opportunities to those given to training post holders. This post will allow you to consolidate your experience in a supportive Acute Medicine environment, giving you wide ranging clinical exposure and training in a progressive Trust that has won numerous national and local awards.

You will be encouraged to acquire USS skills including accreditation in FICE, FAMUS and CUSIC and with a dedicated Clinical Skills lab we are heavily involved in teaching and education. You will work on the AMU as well as the AMAA (ambulatory unit) and support advanced nurse practitioners as well as a large junior doctor team. There is 14 hour day Consultant Supervision on the AMU and it has been voted as one of the best places to train in West Midlands.

The Trust is building the 670 bed Midland Metropolitan Hospital which is due to open in 2022. This new state of the art acute hospital in Grove Lane, Smethwick will bring together all acute services onto one site.

The single-site Acute Hospital will benefit from co-located specialist services which will support the new Emergency Department with dedicated imaging facility and Assessment Units. It will provide state-of-the-art treatment and care for patients from Sandwell and across the region and will become the civic heart of the area and a point of pride for the community.

The Trust is a key partner with the local commissioning group and the local authorities in the Right Care Right Here programme which seeks to deliver a redevelopment of local health services. The programme includes one of the largest investments in the UK with new facilities in both the acute and community sectors. Included within this is the new Midland Metropolitan Hospital.

The Trust has a very good reputation for undergraduate and postgraduate teaching with strong links to the University of Birmingham and Health Education West Midlands. The Trust is home to a number of University departments and we are now looking to develop research capacity in a number of specialties in the Trust including Emergency Medicine so there is likely to be opportunities to become involved in research activities. There is a clinical skills laboratory on the Acute Medical Unit which is the first in the UK.

Birmingham is a vibrant, multi-cultural city and it is a very exciting place to live and work. It has a population of 1.1 million, the youngest in Europe. Its residents speak over 140 languages and blend different cultures and nationalities with history that is rich in industrial heritage.

The area boasts affordable housing with popular residential districts such as Harborne and Sutton Coldfield an easy commute to either of the main hospital sites. There are a number of very good schools and colleges locally (including a number of independent and grammar schools such as the King Edwards Schools). Birmingham is a very green city with more than 8,000 acres of green space including impressive parks around the city. Due to our central location and good motorway connections we are in easy reach of a number of beautiful rural locations including the Peak District, Cannock Chase, the Lickey Hills and the Cotswolds.

For an informal discussion please contact Specialty Lead and Consultant: Dr Sarb Clare Tel-07957147749

Closing date:   28th November 2018

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Doctor warns NHS “running on empty” as winter approaches

A senior medic has warned the NHS is “running on empty” as it heads towards winter.

Dr Nick Scriven, president of the Society for Acute Medicine, said current pressure was an “ominous sign” of what is to come.

“The day-to-day feeling in front door units is that the pressure on them is increasing every day now in terms of the numbers of people arriving and how ill they are when they get to them,” he said.

“Given that we are not yet in November, that is an ominous sign of the ways things will be over the next few months.”

He said this summer the NHS had seen activity levels similar to previous winters, with many hospitals operating “well above” the safe capacity of 85% of beds full.

“In reality, bed occupancy rates have been at more than 95% which is a safety risk to patients and already-stretched staff are not getting a single day’s respite,” explained Dr Scriven.

“We are in real danger of entering our busiest time of the year, with or without a major flu epidemic, with a workforce running on empty in their efforts to help look after those thousands of people who need urgent and emergency hospital care.”

A recent survey of Society for Acute Medicine members – doctors and nurses – showed that 60% of staff felt worse prepared for this winter than last with their major concerns staff morale, community care capacity and staff numbers.

Dr Scriven said: “The views of our members are of much wider concern as they are reflective of the feelings of staff across the NHS and performance figures illustrate just how strained the system is all year round.

“Even in summer we are seeing a steady rise in the number of people needing hospital admission year-on-year – more than 5% in 12 months – and no real change in the services available for them. It’s not sustainable.”

Dr Scriven said there was “still a clear need” for “radical action” to help the NHS survive “what will undoubtedly be a very turbulent winter period”.

“We received much criticism of our call to consider a formal suspension of elective surgery during January and February, yet it is clear given concerns being raised by senior figures that actions, some radical, are needed.

“It had been rumoured that a suspension similar to last year would happen but as of four days ago this has been ruled out.

“The steps taken so far to try to help us weather the storm will barely scratch the surface, so time will tell as to whether or not more drastic measures will be required.”

Acute 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 helps maintain the flow of patients through emergency departments to avoid exit block, the term used when patients cannot be moved into a hospital bed.

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Flu vaccine “an extremely important part” of winter plans

The House of Commons’ Science and Technology Select Committee has released its report into the flu vaccination programme in England following a review earlier this year.

The Society for Acute Medicine would like to thank the Science and Technology Select Committee for seeking our expert opinion in this review.

We agree with the finding that leads them to question the extremely low uptake in social care workers and a large variability in hospital staff uptake of the vaccine.

We agree that the flu vaccine is an extremely important part of annual winter plans and, as such, any initiative that improves vaccination rates in those at risk and those caring for the at risk needs promoting.

As it stands today we do not know the impact influenza will have on us this year but we need to prepare as though it will be as widespread as last year, both with the vaccination programme but also making adequate provision in hospitals for the increase in attendances and admissions we expect to see over the next four months.

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GMC must make efforts to rebuild trust with members – SAM president

Following the publication of a freedom of information request by the Press Association which has revealed the General Medical Council (GMC) spent almost £30,000 fighting the case against paediatric specialist Dr Hadiza Bawa-Garba, Dr Nick Scriven, president of the Society of Acute Medicine, said:

“This was a tragedy on several levels, not least the death of a young boy.

“The ongoing damage is that the medical profession has lost faith in our regulatory body and that the vital learning through sharing experience may not be the same again.

“These figures will shock and further anger the medical profession as the money will have been raised by doctors’ GMC subscriptions and was used in a way the majority of doctors opposed.

“We need the GMC to make a concerted effort to rebuild trust with its members.”

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SAM president praises regulation for “truly valued” physician associates

Following the announcement the government is set to introduce statutory regulation for physician associates, Dr Nick Scriven, president of the Society for Acute Medicine, said:

“We are delighted to hear the news from the health secretary that he is supporting and starting the process to obtain legislation to regulate physician associates.

“They are already a truly valued extra source of skilled healthcare workers and we look forward to the future when they, as he says, can fulfil their great potential.”

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