Cannabinoid Hyperemesis Syndrome – RCEM Guideline

RCEM – February 2024

It is important to recognise that CHS is unlikely to be definitively diagnosed in the Emergency Department (ED) due to the current diagnostic criteria. However, there are many clinical features which can lead clinicians to suspect a diagnosis of CHS and there are several nonconventional treatments that may be efficacious in treating the symptoms of CHS and may help to confirm it. The essential prerequisite for a CHS diagnosis is the long-term use of cannabinoids. There are no laboratory or radiographic investigations that can be used to diagnose CHS. The process of creating this guideline has included contemporaneous literature reviews for high-level evidence in the medical literature on all aspects of CHS, as well as searches for consensus agreement publications where they exist. The guideline group have formed consensus on areas lacking clear answers.

Cannabinoid Hyperemesis Syndrome 

Paediatric same day emergency care – guidance for system leaders, commissioners and providers for developing or improving paediatric same day emergency care services

NHS England – 13th February 2024

This guidance is for system leaders, commissioners and providers who are developing or improving paediatric SDEC services to reduce reliance on overnight admissions for patients who can safely be discharged home on the same day as arrival. It highlights the key principles and minimum standards for this service, including considerations for physical infrastructure, referral and access, workforce, diagnostics, discharge, counting and coding, and patient experience.

Paediatric same day emergency care – guidance for system leaders, commissioners and providers for developing or improving paediatric same day emergency care services

FRAIL strategy – a strategy for the development and/or improvement of acute frailty same day emergency care services

NHS England – 13th February 2024

This FRAIL strategy supports wider healthcare systems to deliver and improve acute frailty services across England by setting out a practical approach. This will mean more older people living with frailty can be safely discharged on the same day they arrive, avoiding admission overnight.

FRAIL strategy – a strategy for the development and/or improvement of acute frailty same day emergency care services

SAMEDAY strategy – a framework for the development and delivery of same day emergency care

NHS England – 13th February 2024

This SAMEDAY strategy supports the delivery of same day emergency care (SDEC) across England in a standardised and consistent way.

SAMEDAY strategy – a framework for the development and delivery of same day emergency care

Service improvement case study: urgent & emergency care department

Patient Perspective – December 2023

The case studies aim to highlight and share examples of service improvements made due to several factors including patient satisfaction scores, issues and themes highlighted by patients from the national surveys and often linked to
feedback from patients from other methods of patient involvement.

Further information – Service improvement case study: urgent & emergency care department

Understanding the rise in 0-4-year-old Emergency Department (ED) attendances and changing health visiting practice

Institute of Health Visiting – December 2023

This report forms part of a suite of resources produced through a programme of work led by the Institute
of Health Visiting. The ultimate goal is to strengthen health visiting services to ensure that all families with
babies and young children are able to access the right support at the right time, to increase their confidence
in managing minor childhood illnesses in the community and reduce the growing pressures on Emergency
Departments. Four supporting documents are presented as standalone appendices:
Appendix 1: A narrative summary of literature exploring the health visitor’s role in supporting parents with
babies and young children with minor illnesses.
Appendix 2: Hampshire case studies (A&B) – Supporting and improving parental confidence in managing
minor illnesses.
Appendix 3: Chat Health case study – Boosting literacy and care: digital parental support via Chat Health
messaging.
Appendix 4: An analysis of a randomly selected group of 100 infants under 12 months old who attended
Northwick Park Emergency Department, North West London.

Read the Report – Understanding the rise in 0-4-year-old Emergency Department (ED) attendances and changing health visiting practice

Health organisations urge lessons must be learned from 2022 emergency care crisis in new joint report

Royal College of Emergency Medicine (21 November 2023)

New joint report by leading health organisations highlights that lessons must be learned from the emergency care crisis in 2022, concluding ‘too many patients are in the wrong place for their needs’.

The report makes a series of recommendations, including:

• Developing and promoting strategies to improve the retention of healthcare workers.
• Reducing the bed occupancy of acute and psychiatric hospitals to 85%.
• Increasing the number of staffed beds in appropriate specialties.

The recommendations are aimed the next government to enable it to work with the health service to improve care with the principles of rebuilding public confidence, improving accountability, seeking innovation and moving away from short-term initiatives and funding streams.

Read the Report – Right Place, Right Care: Learning the Lessons from the UK Crisis in Urgent and Emergency Care in 2022

RCEM National Quality Improvement Programme2021/22 Infection Prevention and Control Year 2 Interim Report

RCEM – April 2023

This Quality Improvement Project (QIP) builds on previous Infection Prevention and Control QIP done in 2020/21 by the College and allows us to see that performance has remained stable with no significant improvement from 20/21 nor across 21/22. The results also show that the average time to movement into a side room has significantly increased from 18 minutes in 20/21 to 61 minutes in 21/22

Further information – RCEM National Quality Improvement Programme 2021/22 Infection Prevention and Control

Access to urgent and emergency care

Public Accounts Committee – October 2023

This report warns of wide regional variations in the quality of patients’ access to urgent and emergency care. It finds that ambulance services covering large rural areas, for example services in the south-west and east of England, were particularly challenged and disproportionately affected by problems stemming from the flow of patients elsewhere in the system. The report further warns that not enough is being done to tackle delayed discharges, with beds unable to be released for new patients.

Read the Report – Access to urgent and emergency care

Chain reaction? Understanding the causes of backlogs through urgent and emergency care

Nuffield Trust – 19th October 2023

‘Gridlock’ of patients in urgent and emergency care is often attributed to a lack of onward capacity for people leaving hospital, leading to delayed discharges that back up the system. But does this explanation often favoured by government and policy makers tell the whole story? QualityWatch investigates whether the pattern is visible in patient journeys through urgent and emergency care at ICS level.

Further information – Chain reaction? Understanding the causes of backlogs through urgent and emergency care