The report argues that the model of ‘admission’ and ‘discharge’ needs to be replaced by one of continuous care, with a named clinician having responsibility for each patient.
The needs of frail elderly patients and people with dementia are not being met, the RCP says, echoing recent policy statements from both the Government and the Opposition.
Guided by a steering group headed by former NICE chairman Sir Michael Rawlins, the report attempts to address failures of care arising from vulnerable patients being ‘discharged’ into a clinical void.
It argues that the same care team should have responsibility for a patient wherever they are, and patients should not be shifted from ward to ward.
To achieve this, hospitals will need more generalists and fewer specialists, with a single organisational structure spanning hospital, primary and social care.
Two new senior roles are recommended: a chief of medicine with responsibility for all adult patients with a medical illness; and a chief resident with responsibility for service design and delivery.
Each hospital should have a clinical co-ordination centre able to keep track of patients, beds, care protocols, and the availability of post-hospital care.
Timothy Evans of the RCP said: “I hope this report will represent a template which can be adapted to the needs of patients in different geographical locations and improve both their care and their medical management.
“We feel this will be achieved fully only where the hospital and wider healthcare facilities, including those related to primary and social care, are unified in their vision and integrated in its execution.”