Service Design & Delivery

The Royal College of Emergency Medicine is dedicated to achieving the highest standards of practice and patient care. Designing and delivering services is at the heart of delivering these standards and the Service Design & Delivery Cluster works to support this. Navigate the below tab menu to explore the resources that have been collated about Emergency Medicine Service Design and Delivery. Find information on current services, delivery issues, what delivering quality looks like in emergency medicine, ED crowding, ED design and system integration and service configuration. There are separate sections for workforce and informatics. Payment mechanisms are within informatics.

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Current Service Delivery Issues

Emergency Medicine is a relatively new specialty, celebrating only its 50th year in 2017. Great strides have been made in terms of improving the quality of emergency care that is delivered, and Emergency Departments are now an indispensable element of the urgent and emergency care systems.

There are significant challenges facing the teams who work in this field:

  • An increasing population means that more patients are attending EDs
  • Lack of alternative healthcare provision, or overstretch in other parts of the system, also drives demand upwards
  • Patients are presenting with more complex needs, and are often elderly, frail or vulnerable
  • Expectations are higher
  • Many facilities and informatics systems are now out of date
  • A combination of poor planning, and lack of investment in the Emergency Medicine workforce, means that there are significant workforce gaps, both medical and nursing
  • Emergency Department crowding caused by all of these factors, but most importantly by exit block, results in long waits in EDs and makes delivering high quality care very difficult

Service Delivery and Workforce Toolkit 2013: Tools to help address service and workforce pressures   

Emergency Departments across the UK are facing considerable service pressures relating to workforce and activity. The College has published a toolkit with the aim of providing assistance to Emergency Medicine clinicians and Departments by listing in one place existing resources together with a description of new developments that we hope will help to address these pressures. It also provides an update on College work to support Emergency Departments and focus attention on finding solutions to the workforce challenges.

This is not a complete resource – where there are blanks the College is working hard to identify or develop resources/guidance, and we are grateful for all the suggestions and good practice examples provided by Fellows and Members to date. If you are aware of existing resources or new initiatives that could appear in this document please contact Sam McIntyre (sam.mcintyre@rcem.ac.uk). Download the toolkit here.

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