Acute and General Medicine
AGM represents the single largest group of inpatients in hospitals, with approximately 2.5m emergency internal medicine admissions every year in England.
AGM services include the assessment, investigation, diagnosis, and management of patients who have an acute medical illness – either the first presentation of an illness (eg; chest pain requiring investigation) or the worsening of an underlying condition (eg; a flare-up of the symptoms of chronic obstructive pulmonary disease).
There are 191 acute medical units (AMUs) in England within 131 trusts (2019/20).
The number of non-elective internal medicine admissions to hospital has been increasing year-on-year over the last decade, with an almost 30% increase (c.600,000 patients) between 2011-2020.
The GIRFT review of AGM services focused on improvements to patient pathways, improving data collection and clinical coding to enable trusts to develop a better understanding of inpatient demand and pressures.
An objective of the national review and its report is to standardise processes and patient care across AGM services. The report recommendations aim to reduce unwarranted variations in both data and practice to enable AGM teams to aim for excellence.
The GIRFT national report for AGM was co-written by Dr Mike Jones and Dr Philip Dyer and published in April 2022.
Acute and general medicine is part of GIRFT’s UEC portfolio >
- AGM Clinical Lead
Dr Mike Jones
AGM clinical lead
Dr Jones practised as a consultant in renal medicine in Tayside from 1992 to 1999. He became involved in acute medicine in 1994 and has been central to the development of the specialty including becoming president of the Society for Acute Medicine from 2005-2008.
Dr Jones is a fellow of all three Royal Colleges of Physicians and has been involved in a variety of national initiatives, including education lead for the Acute Kidney Injury programme ‘Think Kidneys’, and lead clinician and editor of ACUMEN, an e-lfh project.
- Former AGM Clinical Advisor
Dr Tim Cooksley
Former AGM clinical advisor
Dr Cooksley is a consultant in acute medicine at The Christie cancer hospital in Manchester and an honorary senior lecturer at the University of Manchester. He has led the development of an acute medical service at a tertiary cancer hospital and worked for ten years as an acute medical consultant at Manchester University Foundation Trust.
- Former AGM Clinical Advisor
Dr Philip Dyer
Former AGM clinical advisor
Dr Philip Dyer qualified in 1991 and has been a consultant physician in general medicine, diabetes and endocrinology at the Heartlands Hospital in Birmingham since 2001. He was appointed to Heartlands Hospital to develop its acute medical service and therefore developed its AMU from scratch. He was on the council for the Society for Acute Medicine (SAM) for 11 years, culminating in becoming president from 2009-2011.
Dr Dyer was involved the development of Acute Internal Medicine (AIM) as a specialty. He was a member of the special advisory committee (SAC) for GIM and AIM, as the curriculum lead for AIM. He is a Fellow of the Royal Colleges of Physicians of London and Edinburgh.
- Summary of National Report Findings
Workforce and data collection in sharp focus in AGM report
Practical measures which can help improve NHS care for millions of patients with an acute medical illness are outlined in GIRFT’s national report for acute general medicine.
Key aspects of the report focus on workforce (to support a multidisciplinary team approach), location (to support patient handovers, staffing and accessibility), the treatment for sepsis (reduce over-diagnosis) and use of terminology (standardise terms/acronyms used across AGM units).
The report presents 19 recommendations to help trusts support an increasingly elderly and frail population.
Quick links below for AGM best practice guidance and other resources:
- AGM National Report
Click above to view the pdf report
- Acute and General Medicine Video
Watch the video about the Acute and General Medicine report…
Click above to play the AGM national report video
- AGM News