This guideline covers organising and delivering emergency and acute medical care for people aged over 16 in the community and in hospital. It aims to reduce the need for hospital admissions by giving advanced training to paramedics and providing community alternatives to hospital care. It also promotes good-quality care in hospital and joint working between health and social services.
The guideline includes recommendations on:
- first points of contact with emergency and acute care services
- alternatives to hospital care
- services within hospitals
- ward rounds, transfers and discharges
- monitoring and managing hospital bed capacity
Who is it for?
- Commissioners and providers of health and social care
- Health and social care practitioners
- People with or at risk of a medical emergency or acute illness, and their families and carers
We recognise that implementing this guideline will take time, with additional infrastructure and training needed in some areas. Service providers should note where the recommendations are consistent with other national initiatives, especially NHS England’s seven day services clinical standards. See putting this guideline into practice.
Guideline development process
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.