15 Nov 2013

Senior doctors and health professionals from around the UK will be meeting in Edinburgh today at a high-level event which has been convened to reach consensus on how to reduce unnecessary bed moves for patients and improve patient flow, so as to ensure that there is sufficient capacity in hospitals and the community for patients’ needs including times of winter pressure.

The UK Consensus Conference on Patient Flow in Acute Medicine [1], has been organised by the Royal College of Physicians of Edinburgh (RCPE) [2] with support from the Scottish Government. It is anticipated that the consensus reached at the conclusion of the two day event will not only provide invaluable to hospitals throughout Scotland, but also provide a model for wider potential replication throughout the UK.

During the event new data will be presented on a variety of key areas including –

  • the impact of boarding, or unnecessary ward moves, on patients and systems;
  • how to balance planned and unplanned admissions to hospital; and
  • what is the ideal level of bed occupancy and how do we achieve it?

A series of personal perspectives will also be presented covering the experience of patients, doctors, nurses, radiologists, pharmacists and allied health professionals.


The evidence presented during the meeting will be considered by an independent multi-professional panel, chaired by Nigel Edwards, Senior Fellow at the King’s Fund (and former Policy Director of the NHS Confederation). The panel will, in turn, produce a consensus statement based upon this for agreement by all in attendance. At the conclusion of the event a final Consensus Statement will be produced and disseminated throughout the NHS to inform clinical and management practice.


Within Scotland the event forms part of a wider work stream aimed at improving how the NHS responds to unscheduled care, including –

  • a joint RCPE/Scottish Government initiative to reduce the boarding of medical patients  including the development of a bed management toolkit to ensure an adequate number of appropriate beds for acute care, new ways of working for medical consultants to optimise patient flow by ensuring early, daily, review of patients by consultants, and a continuing focus on Health & Social Care integration and reduction in delayed discharges;
  • a joint RCPE/Scottish Government review of acute medical units in Scottish hospitals, during which all 28 acute medical units will be benchmarked; this will be used to develop evidence-based recommendations to improve standards of care and workforce planning [2];
  • a range of Scottish Government initiatives which are already in place to help reduce the boarding of medical patients. These include programmes to ensure safe, effective and person-centred care through initiatives to provide more appropriate alternatives to hospital admission and more effective care through the Unscheduled Care National Programme, the Acute Flow and Capacity Programme and the Cabinet Secretary’s recent commitment to provide the required acute services with senior decision makers and diagnostic capability round the clock, seven days a week.

Dr Mike Jones, Vice President of the Royal College of Physicians of Edinburgh, and a Consultant in Acute Medicine in Durham, said,


“Hospitals and, in particular, acute units can be incredibly busy places with high volumes of patients requiring urgent care on an unscheduled basis. It is critical that patients receive treatment at the right place at the right time, first time, but this has proved an increasing challenge for the health service across the UK. As the demography of the population changes an increasing number of frail and elderly patients who require urgent care will present - acute care has to be tailored to deliver prompt and effective care for all, taking into account specific needs of disparate patient groups.   It is therefore essential that we find ways of better anticipating demand, increasing efficiency and ensuring that there is enough appropriate bed and staff capacity within hospitals for patients to be seen by the right clinician in the right place and at the right time. When this does not happen the quality of care experienced by patients may be sub-optimal, and the pressures on our hospitals are exacerbated. By convening this event we hope to reach a consensus on models that optimise care for patients and promotes better flow through our acute units.”

Alex Neil, Scottish Government Health Secretary, said,

“We are delighted to be supporting this major event which we believe will provide real benefits for patients. The Scottish Government is leading the way within the UK, in tackling the problems associated with boarding. We are undertaking a wide-ranging programme of initiatives to improve the patient experience and journey through hospital, while improving the efficiency of how services are delivered to patients. As the NHS moves further towards being a genuinely seven day service, guidance on how to optimise patient flow and bed occupancy will be of crucial importance and of much value both in Scotland and beyond.”

Contact: Graeme McAlister (RCPE) on 0132-247-3693 or 07733-263453 / Aileen MacArthur (Scottish Government) on 0131-244-2968 or 07747-790476

ENDS


[1] The RCPE UK Consensus Conference on Patient Flow in Acute Medicine will be held at the RCPE, 9 Queen Street, Edinburgh on 15 and 16 November 2013.
Journalists wishing to attend the event and/or interview speakers should contact Graeme McAlister at the above numbers.
[2] The RCPE strives to develop standards of medical care and training, and influence health policy on behalf of physicians and our patients. While based in Edinburgh, the RCPE has over 12,000 members with over half of its UK members based in England & Wales.
[3] Acute medical units are separate from, but closely located to, Accident & Emergency Departments and provide the first point of hospital contact for many severely ill patients referred to hospital by GPs or who become seriously ill while in hospital.