College of Emergency Medicine, Royal College of Paediatrics and Child Health, the Royal College of Physicians and the Royal College of Surgeons.16 July 2014
- This report, based on a summit held in March 2014, and sets out 13 recommendations around urgent and emergency care services.
- Access and alternatives
- Every emergency department should have a co-located primary care out-of-hours facility
- Best practice that directs patients to the right care, first time, should be promoted across the NHS
- Skill mix / case mix
- All trainee doctors on acute specialty programmes should rotate though the emergency department.
- Senior decision-makers at the front door of the hospital, and in surgical, medical or paediatric assessment units, should be normal practice, not the exception.
- Emergency departments should have the appropriate skill mix and workforce to deliver safe, effective and efficient care
- At times of peak activity, the system must have the capacity to deploy or make use of extra senior staff.
- Integration and communities
- Community and social care must be coordinated effectively and delivered 7 days a week to support urgent and emergency care services.
- Community teams should be physically co-located with the emergency department to bridge the gap between the hospital and primary and social care, and to support vulnerable patients
- Seven-day service
- The delivery of a seven-day service in the NHS must ensure that emergency medicine services are delivered 24/7, with senior decision makers and full diagnostic support available 24 hours a day, including appropriate access to specialist services.
- Funding / fair reward
- The funding and targets systems for emergency department attendances and acute admissions are unfit for purpose and require urgent change
- Delivering 24/7 services requires new contractual arrangements that enable an equitable work–life balance
- Information technology (IT)
- It is essential that each emergency department and acute admissions unit has an IT infrastructure that effectively integrates clinical and safeguarding information across all parts of the urgent and emergency care system.
- If configured properly with significant clinical involvement and advice, NHS 111, NHS 24, NHS Direct and equivalent telephone advice services can help to reduce the pressures on the urgent and emergency care system.
- This report follows on from Urgent and emergency care: a prescription for the future
