Acute medicine units: the current state of affairs in the North-West of England.

Studies suggest that acute medicine units (AMU) reduce inpatient mortality, length of stay and re-admissions and improve four-hour performance targets. Over the past decade or so, after evaluating the system in place, the Royal College of Physicians of London (RCPL) has made key recommendations for an efficient and effective AMU. This audit reviews the current infrastructure of regional AMUs against those RCPL recommendations in respect of facilities, service provision and staffing. A total of 22 regional hospitals in the North-West of England were invited to participate in this audit; 19 responded. Two units did not have designated AMU facilities. Not a single hospital met all basic infrastructure recommendations. Only four had the recommended bed capacity, nine had recommended cardiac-monitoring facilities and incorporated 'short-stay units', 13 used early warning systems for patient triage and six had the recommended number of consultants assigned to AMUs with a designated medical team. Notably, there were suboptimal numbers of allied healthcare professionals in most units. In summary, the majority of the AMUs in the North-West of England lack sufficient resources to meet even the most basic RCPL recommendations. A national in-depth audit is needed to determine fully the current state and thus guide future health planning.