Adult Critical Care
About 200,000 people per year in the UK require critical care for many different reasons, ranging from acute medical emergencies, to major trauma incidents such as serious road accidents.
Adult critical care (ACC) is essential to other services in acute hospitals, including emergency and elective surgery, acute admissions and emergency departments.
The GIRFT review identified 269 units providing critical care within hospitals and specialist centres. The resulting national report presented a series of recommendations to improve patient transfers and hospital bed management, and provide more post-operative rehabilitation services.
The GIRFT clinical lead for ACC is Dr Anna Batchelor, a consultant anaesthetist and intensivist formerly of Newcastle upon Tyne Hospitals NHS Foundation Trust.
Dr Anna Batchelor
Adult Critical Care Clinical Lead
Dr Batchelor was, until 2022, an anaesthetist and intensivist in Newcastle. Her anaesthetic interests include patients for endocrine, gastro-intestinal and burns, and reconstructive surgery. She was the past president of the Intensive Care Society (2005 to 2007), and past dean of the Faculty of Intensive Care Medicine (FICM). She is currently a member of the Council of the Royal College of Anaesthetists.
- What is adult critical care (ACC)?
ACC teams care for patients with acute medical emergencies, including surgical complications, major trauma from road traffic accidents and serious burns, as well as specialised care for patients who are seriously ill or at risk from organ failure. These patients require close observation and more clinical interventions than can be provided on a standard ward.
As a general rule, critical care units provide Level 2 care (in high dependency units or HDUs) and Level 3 care (in intensive care units, also known as ICUs and ITUs).
- What is the purpose of the GIRFT ACC report?
Key objectives of the report are to improve patient outcomes and their overall experience of care. Recommendations aim to address the efficiency of patient flow systems (including the step-up and step-down model between Level 2 and Level 3 units) and the function of existing bed capacity.
The report also makes recommendations for improvements to patient recovery and rehabilitation, end of life care and organ donation protocols.
What data sources were used for the ACC report?
The core sources used to analyse ACC services include the Intensive Care National Audit and Research Centre’s (ICNARC’s) Case Mix Programme (CMP) and Hospital Episode Statistics (HES).
The report’s section on procurement uses data from the Purchase Price Index and Benchmarking tool and the section on litigation is based on NHS Resolution
GIRFT critical care report outlines steps to help the NHS cope with future COVID-19 surges
Recommendations to provide more ‘enhanced care’ areas, improvements to transfer services and increasing hospital outreach programmes are among the measures in the report designed to ease some of the pressures on critical care services.
The data-driven review found variation in bed numbers and workforce levels between hospitals, with capacity, culture and resources affecting local decisions on who can be admitted to critical care.
A series of recommendations in the report aim to further maximise the capacity in ACC units (in the case of COVID-19) and avoid the need to delay or cancel surgery for other patients.
Watch the video about the Adult Critical Care report…
Click above to play the ACC national report video