Box 1.

Fundamentals of acute medical care

  • Patients with long-term conditions have self-management plans, including urgent contact number for advice.

  • Local directories of services linked to care advice and navigation services, eg NHS 111, are comprehensive, localised and regularly updated.

  • Direct admission to acute medical services from GP and community services is maximised to prevent overuse or duplication in emergency departments.

  • Acute medical units are appropriately sized for admissions of up to 72 hours and have adequate core equipment.

  • Acute medical units are staffed by multidisciplinary teams to match demand profiles over 7 days.

  • Acute medical services have access to primary care summary records.

  • Same-day emergency care units are led by acute medicine, with access for medical specialities.

  • Access times for urgent and emergency investigations are uniform across the emergency and urgent care ‘floor’.

  • Medical specialities plan daily ‘in-reach’ to acute medical units.

  • Multidisciplinary board rounds, ward rounds and handovers are delivered on all medical units in line with recommendations

  • Pre-emptive discharge planning begins on admission, with planned follow up.

  • Medicines discharge services are maximised.