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Enhanced care: new guidance on service development in the hospital setting

The Royal College of Physicians has been involved in producing new enhanced care guidance from the Faculty of Intensive Care Medicine (FCIM). 

The FICM guidance was produced in collaboration with the Royal College of Physicians, London, the Royal College of Physicians, Edinburgh and Royal College of Physicians and Surgeons of Glasgow.

The document outlines a framework to consider when creating a service for patients whose care needs fall into the gap between what can be provided on a normal ward and in critical care.

By keeping patients as the focus, and accepting that there will be different drivers for implementation, multiple models will be required, so examples are provided of how this has worked in a variety of situations. To ensure there is an overarching governance structure, the guidance recommends a set of principles to follow during development and implementation, including close liaison with critical care so that there can be seamless transition for patients should they need it.

The RCP and the Faculty of Intensive Care Medicine hope that investment in the development of enhanced care services will have an impact on the degree of critical care expansion currently required and be a much more efficient use of resources In light of COVID-19, it also offers the potential to utilise the skills that non-critical care staff have acquired during the pandemic for the continued benefit of patients.

Professor Andrew Goddard, president of the Royal College of Physicians said:
'COVID-19 has taught us more than ever that the interface between wards and the higher levels of critical care is a grey one. This report shows we can improve the care for people in that grey zone and the RCP is delighted to support it.'

Professor Andrew Elder, president of the Royal College of Physicians, Edinburgh said: 
'The flexible nature of this guidance will enable clinicians and their teams to innovatively improve patient care in a way tailored to their local circumstances.'

Professor Jackie Taylor, president of the Royal College of Physicians and Surgeons of Glasgow said:
'The current health crisis has shown us all the need for professional, flexible care if we’re to meet our patients’ diverse range of needs. This guidance will help achieve this, and that’s why we fully support it.'

The full guidance is a available to download here.

Notes to editors

The Faculty of Intensive Care Medicine was founded in 2010 and has well over 3,500 members, making it the largest organisation of critical care medical professionals in the UK. The Faculty is the professional and statutory body for the specialty of intensive care medicine, the doctors who lead critical care services and Advanced Critical Care Practitioners.