Patterns of acute medical receiving in Scotland

The study reviews the patterns of acute medical receiving in Scottish hospitals. Physicians from hospitals with an accident and emergency department and more than 3,000 medical discharges per year were questioned on consultant working behaviour, acute bed usage, the presence of triage and type of geriatric liaison service. The situation as of October 1996 in 26 hospitals is described. In six Trusts consultants have time off other duties to help with acute admissions. In five there is consultant responsibility for acute patients for more than 24 hours, up to a week. Six units have a policy of triage to specialty wards. Eighteen of the 26 units have an Acute Admission Unit (AAU). The needs related geriatric service predominates, but many geriatricians now visit the medical AAU daily. Acute medical receiving systems have been stressed by competing demands and the rise in medical admissions. Most medical units in Scotland have developed new ways of working or are looking at adaptations of their receiving systems.