3. Perils, Pitfalls and Solutions in Acute Medicine Dr Martin Pattrick Consultant in Acute Medicine

4. Background Being a Doctor wasn’t my first choice of career

5. My credentials  Been around a long time !  Experience with various types of hospitals

6. Experience…………… …is what you get when you’re looking for something else.

7. Experience 3 Hospitals: Pennine Acute Hospitals NHS Trust – North Manchester General site University Hospital of South Manchester (UHSM) Tameside General Hospital

8. Main problem Protecting the site at night Some suggestions

9. 1.Nurse recruitment 2.Doctor recruitment Solve these and there’s usually no other recruitment problems Local workforce pressures

10. Nurse recruitment  Mainly working conditions  Physical  Low absence / sickness vacancies  Training – an important aspect

11. Doctor Recruitment  Supportive environment  Office space !  Camaraderie

12. Advanced Nurse Practitioners –Not cheap –Can be extremely effective –Develop protocols –Organise themselves

13. Band 3 / 4 – HCAs / APs –Great help with ward rounds –Results retrieval –Bloods, cannulas, ECGs –Handover facilitation

14. Pharmacy –Train to prescribe –TTOs –Use in PTWR –Discharge summaries in the morning –Early discharge

15. Ambulatory Care If you have one strategy to survive winter….. choose this!

16. Ambulatory Care If it walks… put it in ambulatory care It’s not about closing beds, it’s about making beds work harder Income generation

17. Concept of urgent care –End dichotomy of MAU / ED –Involve the surgeons –Close working relationships –Joint meetings

18. Usual System Patient A&E Trainee A&E Senior Medical Trainee Medical Senior

19. Emergency Dept in-reach PatientA&E Trainee Acute Medical Consultant Patient Acute Medical Consultant OR

20. Top Tips –Get a clinical champion but don’t pay extra! –Arrange for” boots on the ground” –Get ambulatory care up and running efficiently

21. Questions ? Thank You