Acute Care Explained

Acute care provides immediate attention and short-term treatment for severe injuries, illnesses or urgent medical conditions. It is typically delivered in settings like hospitals’ Emergency Departments, Acute Medical Units (AMUs), and specialised care units, ensuring rapid diagnosis, stabilisation, and treatment of people who require urgent intervention. The primary goal is to prevent deterioration, manage life-threatening situations, and, when necessary, transition people to appropriate care levels, such as rehabilitation or in-house long-term care. These services address sudden and unexpected medical needs, such as a severe injury, a life-threatening condition, trauma care and acute care surgery.

For example, Acute Medical Units are vital in the UK’s healthcare system. They offer a bridge between emergency admissions and general ward care, stabilising patients within the first 48 hours and allowing for faster decision-making and treatment. This care model aligns with the NHS’s emphasis on integrated healthcare, aiming for efficient patient management and reduced hospital stays or readmissions. Acute care also collaborates closely with community and primary care services for post-acute recovery and rehabilitation, which can improve outcomes.

What Entails Acute Care?

Acute care is a branch of health services within the broader healthcare system that treats people with short-term, severe medical needs. Unlike long-term care, delivered over an extended period, acute care services help people with sudden symptoms during a brief recovery period. Depending on the person’s needs, this type of care can be delivered in hospital departments or at home.

Acute care includes various clinical interventions, such as trauma care, emergency care, intensive care, critical care, urgent care, and short-term inpatient stabilisation.

Subacute Care

Subacute care refers to a level of care provided to people who no longer require intensive hospital-based care but still require support to regain their independence after surgery or illness, which is offered through home-based or community-based services. People in subacute care often require specialist support, including wound management, tracheotomy, inhalation therapy, or intravenous tube feeding. This care focuses on recovery, rehabilitation, and a smooth transition back to independent living or long-term care when necessary.

Post-Acute Care

Post-acute care covers various medical services related to the person’s steady recovery after hospitalisation for an acute injury or illness. As a part of post-acute care, people can receive rehabilitative or palliative care after their stay in the acute care department. Depending on the level of medical attention needed, these care services may be delivered in a facility, through outpatient therapy, or in the person’s own home.

Post-acute care focuses on:

  • Rehabilitation and Therapy (Physiotherapy and occupational therapy to address physical impairments, Speech and swallowing therapies for those with communication differences and challenges ​ and cognitive rehabilitation for memory, concentration, and thinking skills).
  • Coordination of Care (Care plans developed by multidisciplinary teams, including support workers and social workers, depending on the person’s needs, and support for families and carers to manage responsibilities according to the care plans).
  • Integration with Social Care (Services such as home adaptations help with daily living activities, and mental health support are often coordinated with local authority social services to ensure full recovery).

Types of Acute Care Services

Acute care is an umbrella term that includes a wide range of services meeting the person’s health needs and the complexity of the condition. Choosing the right care is vital for the person and their family. Below is a list of the main types of care services within acute care.

Emergency Care Services

Acute Care in Hospital

Acute care provides medical care as patients recover from illness or surgical intervention. After a few days, a medically stable patient is typically ready to leave the acute care unit. Patients who require a longer recovery can receive care from a skilled nursing facility or transitional care unit.

Trauma and Surgical Acute Care Services

The networked approach to trauma care, with designated significant trauma centres, provides comprehensive services for patients with life-threatening injuries. These centres offer multidisciplinary teams, including surgeons, emergency physicians, trauma nurses, and rehabilitation specialists, available 24/7. Trauma units, meanwhile, provide care for less severe injuries and stabilise patients requiring transfer to major centres. Pre-hospital teams play a crucial role in triage, providing detailed pre-alert information to prepare hospital teams for patient arrival.

Emergency Care

Emergency care covers the treatment of acute bodily injuries or illnesses which, in the absence of immediate medical attention, may lead to severe disability or death. For severe symptoms such as traumatic injuries or serious bleeding, patients should directly go to the emergency room for critical treatment that exceeds what can be provided in a clinic setting. Clinicians in the emergency department provide care for people with a wide range of urgent medical needs, such as stroke, heart attack, dehydration, abdominal pain, or shortness of breath.

Urgent Care

Urgent care services include medical attention for minor health issues and additional services like vaccinations or blood tests. Urgent care centres are a convenient option for people who don’t have a primary doctor or require medical services outside of business hours, but they cannot treat life-threatening conditions.

Intensive Care

Intensive care services deliver specialist treatment to patients with severe symptoms needing constant monitoring and critical medical support. As a part of the intensive care unit (ICU), physicians provide life support to patients with severe illnesses and injuries.

Acute Care at Home

Apart from special hospital departments, community healthcare teams can deliver acute care services in the person’s own home to avoid people being admitted to an acute setting. These teams include several medical experts, including the patient’s GP, specialists, nurse practitioners, and trained support workers. Clinicians who provide acute care at home are equipped with adequate painkilling medicine and patient monitoring devices.

At-home acute care providers support people on a live-in care or visiting basis. At the beginning of the treatment, the support worker is presented with a personalised care plan covering every aspect of the person’s clinical needs. This way, the whole family can be confident that their loved one’s health needs are met in the finest detail.

Acute Care Nursing

Acute care nursing provides specialised care to people with severe, often life-threatening conditions that require immediate and intensive medical attention. These highly skilled professionals work in fast-paced environments such as hospitals, emergency departments, and intensive care units. Their primary role is to assess, identify, and manage people with acute medical conditions, ensuring they receive timely and appropriate treatment.

Acute nursing care covers hospital-based acute care, community and home-based acute care and integration with other care models. When it comes to care quality and safety, the Care Quality Commission (CQC) regulations prioritise person-centred care, which requires a systematic approach to nursing care that includes assessment, planning, implementation and evaluation. Also, the Royal College of Nursing (RCN) has highlighted the importance of adequate staffing levels and appropriate training to ensure one’s safety.

Who Needs Acute Care?

Acute care services are essential for people experiencing an urgent medical condition. Those who typically need acute care include:

  • People with a severe injury or an illness: People suffering from conditions like heart attacks, strokes, severe infections, or traumatic injuries often require acute care services to stabilise their health.
  • People requiring emergency surgery: Situations such as appendicitis, complications from accidents, or other urgent surgical needs necessitate prompt acute care to prevent further health deterioration.
  • Mental Health Emergencies: Adults and older adults experiencing acute mental health crises, such as severe depression or psychosis, need immediate inpatient mental health care to ensure their safety and well-being.
  • Patients with Acute Medical Conditions: Those with sudden medical issues requiring hospital assessment and treatment are often admitted to Acute Medical Units (AMUs) for rapid evaluation and care.

Who Qualifies to Deliver Acute Care Services?

Acute care service units are a regular part of community healthcare services. In terms of management, they are organised similarly to other medical facilities. The staff in acute care is diverse, dedicated, and above all – experienced in the field. At the same time, they are trained to meet every person’s specific needs. The acute care unit usually consists of the following professionals:

  • Doctors Specialising in Acute Medicine:
  • Training Pathway: Doctors enter acute medicine through Internal Medicine Training (IMT) or the Acute Care Common Stem (ACCS) program, followed by four years of higher speciality training (HST) in Acute Medicine.
  • Qualifications: Completion of the Membership of the Royal Colleges of Physicians (MRCP(UK)) is mandatory for entry into Higher Specialty Training (ST4). Additionally, the Specialty Certificate Examination (SCE) in Acute Medicine must be passed before completing training.
  • Advanced Clinical Practitioners (ACPs):
  • Background: Typically experienced nurses or paramedics who have undertaken advanced training.
  • Qualifications: Often hold master’s degree in Advanced Clinical Practice or a related field, equipping them with skills to assess, diagnose, and manage people in acute care settings.
  • Emergency Care Practitioners (ECPs):
  • Background: Generally come from paramedicine or nursing backgrounds with additional academic qualifications, usually at the postgraduate level.
  • Skills: Enhanced capabilities in medical assessment and clinical interventions beyond those of standard paramedics or nurses.
  • Registered Nurses with Acute Care Specialisation:
  • Training: Registered nurses can pursue specialised courses in acute care.
  • Requirements: Typically require at least 12 months of post-registration employment within an acute healthcare setting and an honours degree at 2:2 or above.
  • Paramedics:
  • Role: Provide immediate emergency care and may work in acute care settings.
  • Qualifications: Registered with the Health and Care Professions Council (HCPC) and typically hold a degree in paramedic science.

Benefits of Acute Care at Home

At-home acute care services allow people to receive active medical assistance close to their loved ones in familiar surroundings. Family members’ presence and emotional support broadly benefit a person’s physical and mental health. Staying in the comfort of one’s own home and participating in daily activities step-by-step is significant on a person’s journey towards healing.

Significance of Acute Care

For example, having the company of your pets or watering your plants may be uplifting and motivating during your recovery period. Some people who recover from a critical injury or illness may even draw energy from looking out the window and seeing the familiar sight of their garden, neighbourhood, or nearby parks.

Like all home care providers, support workers who deliver acute care at home prioritise people’s privacy, dignity, and personal boundaries. The clinician team prioritises people’s decisions to provide acute care services in their homes within an at-home arrangement. Therefore, acute care at home is a preferable alternative for all relatively stable patients who don’t require critical assistance from a hospital emergency department.