Admissions

Medical Admissions

Medical patients are usually admitted directly to AMU or Frailty Unit by GPs, or via A&E.

New patients to be clerked are usually seen on AMU and Vickers 3 but, when busy, you may be required to see patients in A&E or on other wards.

For admissions to acute medicine, diabetes and endocrine, gastroenterology, respiratory and geriatrics, the Emergency Department will clerk the patient on Lorenzo including venous thromboembolism (VTE)/Cognitive Assessment, allergy status and prescribing medications.

Admitting junior doctors review the Emergency Department clerking and complete any outstanding tasks. Ongoing care is recorded under “ED Medical Receiving Note”, including name and bleep, and this ongoing care is the responsibility of the admitting junior doctor until the post-take ward round. The post-take ward round is still currently recorded on paper sheets.

You can find a Standard Operating Procedure for this Single Assessment admissions process on Sharepoint (only accessible from an STH computer) via this link: http://sharepoint.sth.nhs.uk/Dept/AcuteMedicine/Shared%20Documents/ There are also some screen share videos on how to use the e-Whiteboard and Single Assessment clerking documents when you are on call, and these can be found on PALMS via this link: https://palms.sth.nhs.uk/course/view.php?id=4801 (you will need your PALMS log in details that you were provided with at induction).

Admissions to other medical specialities are clerked by the admitting junior doctor using the beige paper admission proforma.

All Physician Associate or F1 clerkings should be discussed with a senior and ideally reviewed in person before the end of shift.

General Surgical Admissions

Surgical patients are admitted to the Surgical Assessment Centre (SAC) via A&E or via their GP surgery. 

Generally patients are clerked on SAC, but sometimes it is necessary to go to A&E to clerk.

The FY1/SHO tends to clerk the patients with a senior review after this by the registrar. All patients receive registrar review prior to PTWR.

There is a blue surgical clerking proforma which may have been started by the co-ordinator who sits in A Bay of SAC. The co-ordinator helps to manage the order of patient flow, cannulates, takes blood, and where possible starts completing the demographics and blood results in the blue clerking proforma.

Sometimes surgical patients are admitted directly to the ward via clinic or a consultant. In these cases the juniors on the ward are generally informed and complete the blue booklet.

Elective admissions for operations are usually admitted via the Theatres Assessment Unit (TAU). You may be asked to prescribe analgesia or write a discharge letter for these patients but generally these are done by one of the surgical juniors in theatre.