Website of the Department of Health

A guide to emergency medical and surgical admissions

Published: 26/10/2005

This document provides best practice guidance on emergency medical and surgical assessment and admission as well as the supporting processes that need to be in place. These guidelines aim to extend the high quality of care seen within the A&E department to the rest of the emergency pathway within the hospital and will also contribute toward further embedding the operational standard.

• A guide to emergency medical and surgical admissions

Achieving timely 'simple' discharge from hospital - a toolkit for the multi-disciplinary team

This toolkit provides best practice guidance to simple discharge from hospital. It focuses on practical steps health and social care professionals can take to improve discharge. At least 80 percent of patients discharged from hospital can be classified as simple discharges. Changing the way in which and time of discharge for a large group of patients will have a major impact on effective use of bed capacity and improve patient experience.

• Achieving timely 'simple' discharge from hospital - a toolkit for the multi-disciplinary team

Ambulances

Ambulance improvement checklist

This checklist (updated October 2004) is intended as an aid to all NHS ambulance trusts and their staff to ensure that all possible steps are being taken to improve and streamline the care of patients presenting to emergency care.

• Ambulance improvement checklist

Ambulance trust self-assessment tool

The Department of Health in partnership with the Modernisation Agency has designed a self-assessment tool to help Ambulance Trusts working with their local partners to assess their ability to deliver the NHS Plan and to help enhance the quality of care for patients. It allows Trusts to diagnose their strategic capacity and capability and to identify their priorities for development and support.

• Ambulance trust self-assessment tool
• Analysing ambulance call-cycle data for call connect target

Analysing A&E data

A standard set of core analysis of A&E data developed nationally by the Department of Health and Modernisation Agency, to provide a structure for clinicians and operational managers to identify the particular causes of performance problems

• Analysing A&E data

Bed capacity ready reckoner

A simple desktop ready reckoner has been developed specifically for operational managers enabling you to predict whether you will have sufficient beds or a bed shortage on any particular day, allowing you to take pre-emptive management action to prevent a beds crisis. (Gateway reference 5887).

• Download ready reckoner spreadsheet (XLS, 29K)
• Download instructions for using the ready reckoner (PDF, 20K)

Children and older people - top tips

These short documents provide advice to those working in emergency and urgent care on best established practice in managing these two groups of patients. Both for different reasons can be particularly vulnerable in emergency or urgent care settings. The 'tips' have been developed by the relevant national clinical directors working closely with experienced front line practitioners.

• Tips for quick wins: Improving responses for children and young people requiring emergency or urgent care
• 8 tips for quick wins: Improving responses for older people

Emergency Assessment Unit checklist

Published: 07/07/2003

This checklist is intended as an aide to all NHS Acute Trusts and their staff to ensure that all possible steps are being taken to improve and streamline the care of patients presenting to emergency care.

• Emergency Assessment Unit checklist

Emergency care access algorithm

Identifying actions that have been demonstrated to reduce waiting times and improve the experience for patients requiring emergency assessment and treatment.

• Download algorithm (PDF, 34K)

Emergency care networks checklist

Emergency care networks are a key vehicle in linking all elements of emergency care services to ensure patients receive fast convenient access that is patient focused. This checklist aims to clarify their purposes and makes suggestions for membership and terms of reference. It offers guidance to those who have established, or are setting up emergency care networks.

• Emergency care networks checklist

Faster access

Checklist - Wait for a bed

This checklist is intended to help chief executives and their senior management teams at trust level decide what action they can take to prevent waits for a bed causing 4-hour breaches in A&E. The checklist focuses on the need to match inflows and outflows from beds, improve corporate control of arrivals and discharges from all beds and diagnose any mismatches.

• Checklist - Wait for a bed

Toolkit - Wait for a bed: Bed management further guidance

The wait for a bed toolkit has been designed as part of the wider bed management programme to give trusts guidance in developing strategic thinking to identify operational solutions to resolve bedmanagement constraints.

• Toolkit - Wait for a bed: Bed management further guidance

Faster access: Bed management demand and discharge predictors

This document provides an overview of the functionality and access links to software for bed management demand and discharge predictors, and supports the guidance given in the Wait for a Bed Checklist and the Bed Management Toolkit.

• Faster access: Bed management demand and discharge predictors

Checklist - Wait for a specialist

This checklist (updated October 2004) is intended to help Chief Executives and their senior management teams decide what actions they can take to prevent waits for a specialist causing 4-hour breaches in A&E.

• Checklist - Wait for a specialist

Implementation guide - wait for a specialist

The implementation guide is intended to help Chief Executives and their senior management teams at trust level implement the Wait for a Specialist Checklist to help eliminate these waits for a causing 4-hour breaches in A&E.

• Implementation guide - wait for a specialist

Faster access: Wait for assessment - implementation guide

Time to first assessment, together with waits for a bed and waits for a specialist, is one of the highest remaining causes of breaches against the national Emergency Care Operational Standard. The guidance provided in this document is not mandatory but designed to help manage and reduce breaches caused by waits for assessment.

• Faster access: Wait for assessment - implementation guide

Related letter

• from Duncan Selbie, Director of Programmes and Performance

The Emergency Department: Medicine and Surgery Interface Problems and Solutions

A joint document of the Royal College of Surgeons, the Royal College of Physicians, the Faculty of Accident and Emergency Department; the British Association for Emergency Medicine, and the Department of Health's National Clinical Director for Emergency Access Professor Sir George Alberti. The four organisations joined Sir George to discuss the issues highlighted by the recent four-hour wait emergency target and produce a set of recommendations covering the Department of Health; Strategic Health Authorities; NHS Trusts; and individual managers and clinicians.

• Press release 18 May 2005 on the Royal College of Physicians website (opens new window)

Managing predictable events

Published: 20/12/2004

This is a guide to capacity planning and operational arrangements which can assist in the preparation and management of predictable events which may impact on patients in an Emergency Care setting.

• Managing predictable events

Mental Health Care Checklist

This checklist offers practical support and guidance to help those working in emergency departments, mental health trusts and ambulance trusts to improve the care of patients with mental ill health who access emergency care services. It outlines areas for action and includes examples of the ways in which some services are addressing some of these challenges.

• Mental Health Care Checklist

Patient group direction templates

In October 2003, the Government published 18 new templates. Further templates are under development and will be added to the website over the next few months.

• Patient group direction templates, in the National Electronic Library for Health (opens new window)

Patient Information Tool Kit

This toolkit offers practical support and guidance to help you provide for patients in your emergency department. It is intended for anyone involved in providing information to patients, or in making decisions about how your trust communicates with them. Michael Summers, Chairman of the Patients Association stated "This toolkit is a useful addition to the work being done to improve the environment for patients and to provide helpful information. The Patient Association welcomes this and is fully supportive of it."

• The Patient Information Tool Kit

SHA Top Tips

SHA Chief Executives have developed top tips for SHA Chief Executives, providing a consolidation of the common factors of high performing trusts. These tips are intended to help SHAs to support their trusts in maintaining the operational standard.

• SHA Top Tips