Medical outliers – a ‘wicked’ problem

Abstract

The NHS is facing ever-growing pressures on secondary care with increasing presentations to emergency department and rising demands on inpatient services. Consequently, significant numbers of medical patients are receiving care in ward settings that are intended for the care of non-medical specialties as their primary function. Patients cared for in this setting are termed ‘medical outliers’. At Great Western Hospital every effort is made to care for patients in the most appropriate setting for their needs, however, due to service pressures, particularly in the winter months, a significant number of medical patients are being cared for on non-medical wards. In recent years there has been a reliance primarily on locum staff to see these patients as part of a ‘medical outliers team’. Staff turnover has been high and continuity of care …