The future hospital commission

摘要

Hospital inpatients deserve to receive safe, high quality, sustainable care centred on their needs, which is delivered in an appropriate setting by respectful, compassionate, and expert health professionals. However, fewer hospital beds in the UK than 25 years ago must accommodate the 37% increase in emergency admissions seen over the past decade. Although reduction of the average patient length of hospital stay has helped reconcile this imbalance, the fall has plateaued in the past 3 years, and has started to reverse for patients older than 85 years, who present frequently with multiple comorbidities including cognitive impairment and general frailty. Although emergency admissions fall at weekends, findings from some studies show rises in out-of-hours mortality. In the UK, recruitment into emergency medicine is becoming increasingly difficult, and trainee physicians are actively avoiding specialties that include duties as a general medical registrar.