Royal College Praises Emergency Assessment Unit
The Norfolk and Norwich University Hospital's Emergency Assessment Unit has won praise from the President of the Royal College of Physicians for setting high standards of training in acute and general medicine.
Following a recent visit to the hospital's Emergency Assessment Unit (EAU), Professor Carol Black said the unit was an excellent example of how acute and general medicine was a valid speciality in its own right.
The NNUH has been a pioneer in emergency medicine ever since a Medical Assessment Unit was created at the old Norfolk and Norwich Hospital ten years ago. Since then the number of medical emergency patients admitted each month has risen from 400 to 1400.
Professor Black's comments come as the Trust hopes to appoint a third Consultant specialising in acute and general medicine to join Dr Paul Jenkins and Dr Robert Mallinson. This follows the introduction of a specialist training programme for registrars at NNUH.
The four-year programme has the backing of the Royal College of Physicians and aims to give qualified doctors the experience they need to diagnose acutely ill patients when they come through the doors as an emergency.
The trainees join a rotational programme which takes in the James Paget Hospital, the Queen Elizabeth Hospital in King's Lynn and Peterborough General Hospital, as well as NNUH.
“With such a high number of admissions, our medical teams need access to senior opinion round the clock,” says Dr Jenkins. “Our training programmes are designed to ensure that doctors have the relevant experience and confidence to deal with patients who are critically ill from a diverse range of conditions.”
“The Trust has been visionary in devising training programmes and procedures to deal with these very challenging cases, ” explained Dr Jenkins, who has been a consultant physician at the NNUH for more than 22 years.
“Our new training scheme recognises the importance of good teamwork and the need to treat the patient holistically, rather than concentrating on a specific range of problems or symptoms. It also emphasises the skills required in the management of the critically ill patient and, to this end, there is a large formal component of intensive care medicine included in the programme.”
The initiative to create a new speciality in acute medicine began five years ago with the creation of a national Society of Acute Medicine. This is now a 150-strong group with representatives from various disciplines including nurses, anaesthetists and physicians.
Dr Jenkins is president of the Society, which aims to promote training and development and set standards in acute medicine.
“The following list of 'firsts' we have achieved in recent years shows how much the EAU team has to be proud of,” he added.
- 1994 The first Medical Assessment Unit (MAU) in the country was created at the old Norfolk and Norwich Hospital to deal with acutely-ill patients. Now known as the Emergency Assessment Unit, this is split between surgical and medical patients who require rapid diagnosis and a high level of individual care.
- 1995 The Trust began training senior nurses to take emergency calls from GPs who need advice in treating acutely-ill patients. This has been a great success and is now emulated by hospitals all over the country.
- 1996 saw leading-edge work between MAU and the Norfolk Mental Health Care NHS Trust in developing a psychiatric nurse-led service to help those suffering from self-harm.
- 1996 An outpatient service for patients with deep vein thrombosis (DVT) was pioneered out of MAU by the haematology team, led by Dr Jennie Wimperis. This service has since won the prestigious Nye Bevan Award and has been emulated by numerous hospitals throughout UK.
- 1997 A pioneering training scheme for anaesthetists specialising in intensive care to develop skills in acute medicine was developed by the Trust. Since then, 12 anaesthetic trainees have completed attachments and this has proved to be a highly successful initiative. “It is particularly beneficial to have doctors from different backgrounds combining their skills in treating severely ill patients and the project looks likely to be extended to national training programmes, ” says Dr Jenkins
- 2003 England's first recognised training programme for registrars in acute and general medicine commenced in North Anglia, centred on NNUH.
- 2003 The first wave of senior nurses was trained to admit, examine and start treatment for patients was commenced in EAU. Only a few hospitals in the UK have similar services.
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