New principles issued to improve the flow and experience of patients through urgent and emergency care

The principles – underpinned by existing national policy and expert clinical opinion – pinpoint ways of working that NHS teams should promote and deliver to help improve patient flow and their overall experience.

Working together, operational teams and clinicians can use these practical guidance points to gauge whether their service is delivering the care and necessary inter-specialty working as described, identify any gaps or inadequacies, and collaborate with colleagues in specialty teams and the trust executive to ensure the principles are supported and implemented. ​

The guidance is offered under the overarching principle that ‘patients should have equitable access to professionals with the skills required for ​their individual care, independent of the location of their bed or the nominal admitting specialty’.​ As well as the 10 principles for acute patient care to help the functioning of the Acute Medical Unit and guide specialty input into acute care, it also features four core principles for effective delivery of patient care in same day emergency care (SDEC).

Royal College of Physicians (RCP) clinical vice president, Dr John Dean, who leads joint working with the GIRFT programme said, ‘We know that delivering acute care for medical patients needs joint working of specialties. These principles bring together much previous guidance into a single place. Local clinical leaders across specialties should work with operational colleagues using these principles to enable the care delivery they want to provide. Locally agreed patient dispositions are an important part of this, and the examples shown give a good basis for local implementation or adaptation.’

Alongside the principles and practical guidance, the document contains examples of patient dispositions for common conditions which can be modified locally. The examples are based on the premise that the main presenting complaint will determine which specialty the patient is referred to and which specialty admits the patient.

An evaluation checklist is also provided for regular monitoring of implementation and delivery of the principles, to ensure they are embedded.

Further reading

View the full list of Acute care toolkits.