Intended for healthcare professionals


A&E: Move patients to wards regardless of bed capacity, to spread risk, says royal college

BMJ 2022; 379 doi: (Published 25 October 2022) Cite this as: BMJ 2022;379:o2557
  1. Elisabeth Mahase
  1. The BMJ

A “continuous flow model” of care whereby patients are transferred from the emergency department into wards whether or not beds are available could be rolled out across England.

The system, also known as the proactive flow model, is being considered for national roll out by NHS England but is already being trialled locally by some trusts.12 One such trust in Bristol sees one patient moved to acute admissions every hour and one to the frailty unit every two hours.3

The scheme can mean patients having to share a bay or side room with another patient. It aims to reduce numbers of ambulances queuing outside emergency departments and to encourage wards to discharge and so reduce blockages in patient flow.

The model has divided clinicians, with some arguing that it could harm patients,4 while others say that spreading the risk across the patient pathway, rather than concentrating it in A&E, reduces the risk.

Adrian Boyle, president of the Royal College of Emergency Medicine, told The …

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