A to Z of services

The acute medical unit (AMU) offers rapid access to adult inpatient and diagnostic services, seeing more than 800 patients per month since it opened in December 2012.

The unit has 42 beds for seriously ill patients referred from the Emergency Department or via GPs through the ambulatory emergency care unit.

The unit also houses a dedicated area to monitor and provide optimal care for seriously ill patients that have a high medical need but fall short of the criteria to enter the high dependency unit (HDU). This group of patients will receive ongoing assessment and are stabilised before being admitted onto a hospital ward.

A large multidisciplinary team of 9 consultants, over 40 nurses, dedicated pharmacists, allied health professionals and health care assistants offer patients an efficient, prompt service & quality care with the aim of:

• Avoiding unnecessary hospital admissions
• Identifying appropriate admission to hospital wards
• Reducing length of stay
• Safe onward referral to community services

This is facilitated by a robust daily multidisciplinary team meeting attended by doctors, the senior nurse on charge, a physiotherapist, occupational therapist, a representative of the social service department and a bed manager.

This consultant-led service offers prompt and efficient expert care to a diverse range of clinical needs with consultant presence in the unit between 8am to 5pm on weekdays. An AMU consultant is on-call from 8:30am to 8:30pm on weekdays and 8am to 2pm on weekends.

The unit is supported daily by a variety of acute physician consultants specialising in a number of areas including:

• Respiratory medicine
• Renal medicine
• Diabetes and endocrinology
• Hypertension
• Cardiology
• Clinical pharmacology

This ensutes patients receive the most appropriate care quickly and when they need it.

Consultant-led ward rounds are performed twice daily on weekdays and once daily (a morning ward) on weekends and bank holidays - ensuring early review and discharge to either home or community care, or transfer to an appropriate ward.

In addition, AMU has a comprehensive governance structure with a robust system for accountability and assuming responsibility. The protocols and policies are evidence-based, quality-assured, cost-effective and consistent with relevant national clinical guidelines.

Location

Acute Medical Unit, 1st Floor, London Wing, (Blue Zone) 
Croydon University Hospital
530 London Road
Croydon, CR7 7YE

Referral to service

AMU - Patients are not referred directly to the Acute Medical Unit from an external source. Patients who are appropriate for this ward are identified by a medical consultant during the post take ward round, or by the on call medical registrar – overnight during the acute medical on call take.

AECU - This is a pathway driven service into which patients can be referred, either by their GP (primary care) or via the Emergency Department (secondary care).

Referrals into the service are made to an AMU Consultant via a dedicated mobile phone number between 9am and 4pm, or internally via bleep 707.

Related Service - Ambulatory Emergency Care Unit (AECU)

Patients referred into this service must be mobile and can arrange their own transport.

The clinic is open from 9am to 6pm and is supervised by an AMU Consultant supported by nurse practitioners, junior doctors & health care assistants.

There are two main categories of patients which can be referred to this pathway driven service. Either patients which are amenable to a “one-stop” assessment and treatment for example suspected deep vein thrombosis (DVT), low risk pulmonary embolism (PE) or patients appropriate for a short course of ambulatory intravenous treatment e.g. cellulitis for IV antibiotics or iron deficiency anaemia for parenteral iron replacement therapy.
One of the key goals of the AECU is supporting admission avoidance.

Related Service - Rapid Assessment Medical Unit (RAMU)

This unit has 12 trolley bays and one side room. It is staffed by senior sisters, nurses and healthcare assistants and is an assessment area where patients are reviewed first by a junior doctor then by a Consultant on the “post take “ ward round. The aim is supporting early senior review and efficient bed utilisation. Patients can either be discharged home, admitted to the Acute Medical Unit (if the estimated date of discharge is within 48 hours) or for those patients in whom it is anticipated the inpatient stay is likely to be greater than 48 hours, transfer to a general medical ward under the care of the relevant specialty team, when possible, e.g. respiratory, renal, cardiology gastroenterology is the outcome.

Related Service - Acute Care of the Elderly Unit (ACE Unit)

This 12-bedded unit is staffed by senior sisters, nurses and healthcare assistants, supported by physiotherapists, occupational therapists and social care workers. It is a Consultant led service with  with daily ward rounds  by  a Consultant Geriatrician. One of the primary goals of this unit is to offer comprehensive and focused multidisplinary support for patients over the age of 80 to encourage rapid recovery and minimise inpatient hospital stay. Patients appropriate for this unit are usually those in whom it is anticipated that the acute medical issue will require no more than 48 hours of inpatient care.

Related Service - Other Clinics

• Hypertension clinic - Dr. Akunuri on Wednesday afternoons
•  AMU Follow- up clinic - Dr. Iyer on Monday afternoons
• AKI clinic - Dr. Prakash on Wednesday afternoons

Further Information For Patients

Visiting hours are 2pm to 5pm and 6pm to 8pm.

Visitors are limited to two per bed at any one time. If more people need to visit together please check with the nurse-in-charge. Children are welcome but they remain the responsibility of the adult visitor. It is suggested that visits, which include children, should be limited to a maximum of 30 minutes.

If visiting please pay particular attention to any infection control instructions. Your best protection against any virus is thorough hand washing with soap and water.

Flowers are not allowed on the Acute Medical Unit (AMU) this is for the safety and comfort of the patients.