Shake-up 
call over acutely ill patients

Acutely ill hospital patients should have access to consultant doctors for at least 12 hours a day, seven days a week to reduce the number of hospital deaths which occur out of hours, leading physicians have said.

The Royal College of Physicians (RCP) said patients admitted at weekends were more likely to die than those admitted during the week.

Launching new guidance on the way acute care should be provided, the RCP and the Society of Acute Medicine (SAM) suggested that one specialist should be dedicated to caring for acutely ill patients every day.

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Doctors should check on patients in acute medical units (AMUs) at least twice a day, the guidance added. It also suggested that diagnostic services should also be available around the clock.

Dr Mark Temple, acute care fellow at the RCP, said: “Consultant review of acutely ill patients 12 hours a day, seven days a week is key to the delivery of care that is of the highest quality on the AMU.

“AMUs, together with emergency departments, are the busiest clinical areas in the hospital.

“Hospitals struggling to cope with increasing emergency admissions can use the toolkit to reconfigure acute medical services and ensure that daily consultant review is integral to the provision of high-quality care to patients with acute illness.”

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SAM president Dr Chris Roseveare added: “The presence of a consultant on the acute medical unit is essential to ensure high- quality, safe, effective patient care.

“Clinicians and managers now have the opportunity to calculate the workforce which they will require to deliver this, based on factors such as the size and configuration of the AMU, as well as the numbers of patients admitted on a daily basis.

“This is a landmark in acute medical care and represents a major step forward for the treatment of patients admitted to hospital in an emergency.”

Health Minister Lord Howe said: “We want patients to get the same level of service on a Saturday or Sunday as they do on a Wednesday.

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“This is a great example of doctors leading the way in driving up standards of care in the NHS. We recommend hospitals take note of this guidance to ensure their patients are getting access to the best quality of care seven days a week.”

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