• emergency care systems

‘All hospital inpatients deserve to receive safe, high-quality, sustainable care… delivered in an appropriate setting by respectful, compassionate, expert health professionals…hospitals are struggling to cope with the challenge of an ageing population and increasing hospital admissions’. So says the Royal College of Physicians (RCP) of London in a report published in September last year. Called ‘Hospitals on the edge? The time for action,’ it is a clarion call to action1 and sets out the magnitude of the challenges facing acute care services. The College says it is increasingly clear that a radical review of the organisation of hospital care is needed; action is needed now and it must be done collaboratively.

Statements like these, from such an august body, deserve to be taken seriously. The report is not political shroud waving seeking attention for the sake of it but is a sobering read; it will be of interest to many readers of this journal, particularly the UK ones.

A few key points are listed below:

• There are a third fewer general and acute beds now than 25 years ago, but the last …