Chelsea and Westminster context and pilot scope
Chelsea and Westminster Hospital NHS Foundation Trust is a 475 bedded acute inner London hospital. It has 3000 staff, 70,000 admissions per year, and 113,000 A&E presentations. The Acute Assessment Unit was set up in 2010 as a response to increasing pressures on A&E services. It treats on average 74 patients per day, and has a dedicated team of medical, surgical, nursing and therapist staff. The unit is a joint Medical Assessment Unit, Surgical Assessment Unit and Coronary Care Unit. It has both trolleys (10) and beds (44). It is staffed by a surgical team and medical team doing 4 month rotations, with 6 consultants, 4 registrars, 9 SHOs and 6 HOs, a nursing team of 61, highly skilled with additional training to support the unit’s work, a small pharmacy team of 1 pharmacist and 1 pharmacy technician and a small team of therapists (physiotherapists and occupational therapists with additional training) shared with the rest of the trust. It is open 24hrs a day, 7 days per week. Patients are initially assessed in the unit and a decision made on their estimated LOS. Patients with an expected LOS of less than 48 hours remain on the unit and greater than 48 hours are admitted to an appropriate ward in the hospital. Patients present to the unit from A&E or direct from GPs. GPs go through a telephone triage prior to the patient presenting to the unit