Doctors set four-point NHS plan for “radical and positive change”

The Society for Acute Medicine (SAM) has set out a four-point plan to create “radical and positive change” in the NHS.
To coincide with the organisation’s Acute Medicine Awareness Day (Tuesday, 14 June), its president Dr Mark Holland called on NHS leaders to take action to ensure “an enduring future” and help the healthcare system “work properly again”.
In a document entitled ‘State of the nation: More than ever, better is possible‘, he warned urgent and emergency care across the country remains “under sustained and unprecedented pressure” – despite cold weather being “a distant memory”.
“Hospital trusts continue to be singled-out for criticism by external bodies and the media but, as anyone who really understands the modern NHS knows, in a competitive system of finite resources which is driven by targets, there will always be “losers” as well as winners,” explained Dr Holland.
“To address this imbalance, we need to see radical and positive change and NHS leaders and the government must work with us adopt and adopt a new paradigm.”
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 to hospital as emergencies.
“Acute medical units play a vital role in preventing our over-stretched emergency departments from toppling over and the specialty has been at the forefront of developing sustainable seven-day services,” said Dr Holland.
“We continue to lead in implementing changes to make our NHS work properly again – we have fresh ideas and are prepared to challenge conventional practice, but we must be listened to.”
Earlier this year, SAM raised concerns about the continued pressures facing the NHS following the release of performance data for January which were dismissed as “patent nonsense” by the Department of Health – despite the further record poor performance levels which followed.
He said: “The NHS has no doubt been in crisis, so persisting in dismissing warnings from medical professionals and organisations working on the frontline is not acceptable or conducive to improvements.
“The first point of our plan is to finally see acceptance that the current system does not work and cannot be patched up, then NHS leaders must work with us in acute medicine as we have shown the greatest ability to adapt and change.”
Dr Holland said there needed be a drive to ensure all acutely unwell patients are cared for by diverse teams of professionals – including doctors, junior doctors, physician associates, specialist nurses, nurses, healthcare assistants, physiotherapists and pharmacists – led by senior clinicians.
He added the NHS should move away from “obsessing” over the four-hour emergency access target and focus on a range of patient outcomes and quality standards to measure pressures and take effective action.
“Other factors, such as the number of black alerts and capacity-related major incidents, daytime bed occupancy figures, patients moved to non-specialist wards and timeliness of senior clinical reviews, should all be considered when assessing pressures,” he said.
“We may then be in a position where we have a much clearer idea of what is happening and, combined with seven-day services and an NHS willing to listen to ideas to improve, begging to see the service functioning properly once again.”
For more information, visit the ‘State of the nation: More than ever, better is possible‘ news article. 

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