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Medicine Clinical Academic Group

Organisational unit: Clinical Academic Group

Organisation profile

Summary

The Medicine CAG has four major specialties primarily focused on urgent care, and has responsibility for two Emergency Departments and more than 20 wards.

Our specialties are:

• Emergency Medicine

• Acute/General Medicine

• Geriatric Medicine

• Clinical Toxicology

These clinical services interface with other services within the hospital and community including primary care, community care, social care and the third sector. For acute care the development agenda revolves around reduction in acute hospital based care to be substituted by higher quality care that involves either shorter stays in hospital, ambulatory emergency care or a community acute response.

We have developed close working relationships with Mental Health of Older Adults and Dementia CAG (Dementia programme), Addictions CAG (alcohol strategy), Palliative Care (End of Life Care and the AMBER care bundle), Psychosis CAG and Psychological Medicine CAG. Our executive has representation from Therapies, Pharmaceutical Sciences and the Guy’s and St Thomas’ Community Directorate.

 

CAG Structure

Dr Adrian Hopper – Co-CAG lead

Mrs Sue Bowler – Co-CAG lead

 

Development programmes

 

The Medicine CAG has played a lead role in two important King’s Health Partners’ programmes:

• Southwark and Lambeth Integrated Care – to improve the care of frail older persons and those with long term conditions.

• Homeless Persons Project – a more integrated approach to the care of homeless people.

 

One of the principles of this work has been to develop as similar a response as possible for both King’s College Hospital and Guy’s and St Thomas’, for example a telephone hotline to opinions of a geriatrician, and an integrated Homeless Team.

New ways of working – the challenge of frailty

The Medicine CAG has developed a number of models (e.g. OPAL and KOPAL) based around the use of Comprehensive Geriatric Assessment to recognise and respond to the needs of Older Persons in Acute Medicine, Surgery and Oncology which have spread widely in the NHS.

Scorecard – value based healthcare

The Medicine CAG has been one of the first CAGs to develop a scorecard. Our CAG has the advantage of having two hospital services that have similar community interfaces – our challenge is how we can use this data to learn from each other.

Patient Safety and Nursing Quality

Nursing in the Medicine CAG has developed a ‘Twinning’ concept to take the AHSC and CAG meaning to all staff on the wards. Each ward has been twinned and reciprocal visits have occurred, with initial overviews and then moving on to consider and compare specific areas of quality, benchmarking and learning. A Nursing Board has been established and key actions agreed including: King’s Health Partners falls work; education around Sage & Thyme training; and comparing data on degree based professions. Next steps for the Nursing Board are: to use the dashboard/cockpit for sharing and understanding patient experience; to share staff levels and skill mix to ensure that the quality agenda is not only high on the Medicine CAG’s agenda but that real working steps are being made for consistency; to make contact with our SLaM partners to start twinning work with the Maudsley to progress the dementia agenda.

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