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OCT 15/2014

Can trainees and community care reduce pressure on acute services?

A new industry call has been issued for more jobs for medical graduates to be created in order to help address the growing challenges being faced by the acute care sector at the moment.

Published last month, a report from a trio of royal colleges representing UK medical staff suggested that greater use of medical trainees - plus the deployment of a wider range of services - could be essential to transforming the current structure of the NHS in order to better cope with demand from patients.

Given the government's stated commitment to helping ease the burden on emergency departments and acute care providers, such recommendations could be vital to securing the ongoing sustainability of the health service.

Why more medical trainees may be needed
The Royal College of Physicians of London, the Royal College of Physicians of Edinburgh and the Royal College of Physicians and Surgeons issued their joint statement last month to raise awareness of the fact that there is currently a shortage of core medical trainee doctors who are either specialising in acute medicine or dual accrediting in general internal medicine.

Given this is occurring at a point when the number of acute hospital admissions is rising, this could increase pressure on acute medical units across the UK unless addressed.

As such, the organisations called for NHS decision-makers to invest more money in creating additional training posts and considering innovative solutions to fill recruitment gaps, such as using international medical graduates, rather than becoming over-reliant on locum staff. 

The report also called for more effective use to be made of the entire medical workforce, ensuring that everyone from nursing and clerical staff, physician associates and phlebotomists to acute specialist clinics and community services are involved in patient care.

Professor Derek Bell, president of the Royal College of Physicians of Edinburgh, said: "Our longer-term shared goals must be to grow the workforce and to restore a more appropriate balance between service delivery and the standards of training. Trainee satisfaction levels relating to being on call for acute medicine must improve."

How the NHS can benefit these changes
The royal colleges' statement aligns with the current government stance that more needs to be done to ensure emergency departments are no longer seen as a first port of call for any and all medical complaints or problems.

Research from the College of Emergency Medicine, Royal College of Paediatrics and Child Health, the Royal College of Physicians and the Royal College of Surgeons suggests that 25 per cent of all admissions to emergency departments are children and young people - and that up to 16 per cent of them could have their conditions effectively managed outside a hospital setting.

Making greater use of the full range of medical staff and services will help to correct this balance, but even as the focus of care moves away from the acute sector, it remains essential for this field to be adequately staffed and properly resourced, due to its essential role in caring for those in the most urgent need of treatment.

Sir Richard Thompson, president of the Royal College of Physicians of London, said: "We need new systems that deliver care where patients need it, supported by a workforce skilled in treating patients with multiple complex conditions."

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