Acute Care Fellow: a brief introduction

Abstract

Chris Roseveare has kindly invited me to introduce myself through this ‘Guest Editorial’ page of Acute Medicine. I was appointed to the new post of Acute Care Fellow at the Royal College of Physicians of London in July of this year. This is a new post, created by the College in recognition of the immense pressures currently being experienced by acute medical services. The remit includes identifying the difficulties faced by physicians in delivering high quality care and seeking out and sharing examples of good practice. I will chair the new acute medical care committee at the College which will have wide representation from all medical specialties involved in the provision of acute medical care. Acute medical units are the hub of the acute medical take and acute medicine will be well represented on the new committee with SAM consultant, trainee and nursing representatives. One practical work stream that is underway is a series of acute care toolkits commissioned by the College. The first on “Handover” was published in May 2011. The second, “High quality acute care”, has just been launched and is available on the Royal College of Physicians’ website: http://www.rcplondon.ac.uk/press-releases/new-toolkit-support-high-quality-care-acutely-ill-patients The toolkits focus on problem areas in acute care and provide practical advice, examples of best practice and recommendations. “High quality acute care” lists 14 key principles of acute care, drafted in close consultation with SAM. One particular concern is the evidence that the outcomes for patients admitted as medical emergencies at week-ends are inferior to those admitted on weekdays. In November 2010 the RCP issued a statement that “Hospitals undertaking admission of acutely ill medical patients should have a consultant physician on site for at least 12 hours per day, seven days per week”. Most acute hospitals are well on the way to providing this level of cover on weekdays – but weekends and bank holidays continue to present a major challenge. The RCP will be working closely with SAM to look at ways in which changes to staffing patterns at weekends can be realised, including reorganisation of rota patterns. Recommendations will be incorporated into a later toolkit.