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Acute and emergency care: prescribing the remedy

Acute and emergency care: prescribing the remedy is published today jointly by the College of Emergency Medicine, Royal College of Paediatrics and Child Health, the Royal College of Physicians and the Royal College of Surgeons. This report sets out 13 recommendations to address the challenges facing urgent and emergency care services across the UK and Ireland.

Given the continuing challenges experienced by patients and those working in acute and emergency care services the College of Emergency Medicine convened an emergency summit. On 4 March 2014 key policy makers, opinion formers and leaders in acute healthcare were brought together to develop solutions to the challenges. Key challenges discussed included rising acuity levels, providing alternatives to emergency departments, complex discharge and community integration, emergency department crowding and patient flow, acute care workforce recruitment and retention and meeting specific patient group needs.

This report contains the consensus recommendations of this summit. The consensus nature of the proposals reflecting the needs of patients whether ill or injured, the elderly and children is unique.

The Royal College of Physicians president Sir Richard Thompson said:

Over the past few years, services for ill patients have been stretched by the sheer amount of acute and emergency admissions, and we have to plan better for the future to protect patient safety. These 13 recommendations are practical, evidence-based, and produced by doctors who care for patients daily – if we do not implement them, we shall simply walk blindfold into another winter crisis.

President of the College of Emergency Medicine, Dr Clifford Mann said:

The College of Emergency Medicine has been pressing for action to tackle the challenges facing the acute and emergency care system. If we are to avoid an annual crisis and build a resilient system it is vital that the 13 recommendations within this unique document are implemented. No plans for acute and emergency care should be developed without reference to these consensus recommendations. It would be nothing short of a scandal if these recommendations were not acted on. The time for action is now.

Dr Stephanie Smith of the Royal College of Paediatrics and Child Health said:

Emergency departments are being put under increased pressure as staff are faced with growing numbers of patients who are either unable to access out of hours care or who see emergency departments as the ‘go-to’ for all health complaints. We already know that 25% of all admissions to emergency departments are children and young people and we estimate that up to 16% of these could have their care effectively managed outside the hospital setting - a significant number that if addressed, would reduce pressure on units. What we need to do now, and as today’s report highlights, is have better access to out of hours primary care, provide doctors with appropriate training and access to advice from paediatricians, and have more effective and consistent advice and information sharing between healthcare professionals to reduce unnecessary admissions – crucial for a parent’s confidence in managing a child’s long-term health condition.

Miss Clare Marx, President of the Royal College of Surgeons, said:

These practical recommendations, put forward by clinicians working in our very busy Accident and Emergency service, would help tackle the current challenges and improve care for all patients. Particularly important, is the need for community and social care services to be co-ordinated and delivered across seven days a week to support our emergency care system.This report shows it will need a change in system culture to remove many of the current obstacles which prevent patients in hospital from being transferred back to their own home and this will not be easy. Clinicians, managers and social care agencies working together to implement these recommendations will make progress. This will facilitate further improvements for patients who need urgent care.


For more information, please contact Linda Cuthbertson, head of PR, on 0203 075 1254 / 0774 877 7919, or email Linda.Cuthbertson@rcplondon.ac.uk