The Trust was one of the first in London to set up an Acute Medicine service in 2004. The service was redesigned in 2010 and has expanded to provide multidisciplinary assessment, stabilisation and treatment of acutely ill adult medical patients of all ages with an anticipated length of stay of up to 72 hours in the Clinical Decisions Units (CDU) and Short Stay Wards (SSW). Dedicated consultants in Acute Medicine provide the service with support from the general physicians within the Trust.
Clinical Decisions Units (CDU) and Short Stay Wards (SSW)
The CDU accept direct medical referrals from GPs and medically referred patients from the A&E departments. The service allows emergency medical patients to be assessed by specialty teams away from the A&E department in a more comfortable environment for patients and relatives. A senior decision maker, often the Consultant, is involved in the initial assessment, treatment and decision making regarding the need for admission or safe discharge. Those patients needing admission are triaged from the CDU following either into the SSW or into one of the specialist medical wards. The CDU has 12 hour Consultant presence each week day with plans to expand this to 7 days a week. Patients on CDU continue to have on-going Consultant review. Patients have rapid access to diagnostics services.
The Short Stay Ward has dedicated Consultant cover 7 days a week providing senior input into patient management and continuity of care, with daily Consultant led ward rounds and multidisciplinary board round.
The Acute Medicine department also provides an outpatient DVT (deep vein thrombosis) and mild PE (pulmonary embolism) service, an outpatient Parenteral Antibiotic Therapy service and an Acute Medicine clinic to support earlier and safer discharge. The department is currently developing acute admission avoidance clinics.
The CDU and SSW have a dedicated team of senior and junior medical staff, nursing staff and Allied Health Professionals including physiotherapists, occupational therapists and pharmacists, to ensure appropriate management, liaison with community based services and safe and coordinated discharge of patients back to the community.
GP referrals at Chase Farm Hospital are made through the switchboard (0845 111 4000) to the medical registrar. Assessments take place either in the A&E department or on CDU.
GP referrals at Barnet Hospital are made through the direct access number 020 8216 4776 to the CDU nursing staff and passed on to the medical registrar or the Consultant on CDU should the GP wish to discuss a patient. Most GP patients are assessed in CDU.