THE Acute Medical Unit (AMU) at Salisbury District Hospital sees between 10,000 and 11,000 patients every year.

Patients are either sent to the unit by their GP or come via the hospital’s Accident & Emergency.

Consultant Stuart Henderson who is the clinical director for medicine at the hospital said: “The AMU has really been developed over the last 10 to 15 years to manage unscheduled care admissions coming into hospital.

“The media always talks about the numbers attending A&E but a big chunk of people will be bypassing A&E and coming straight to AMU.

“We deal with medical problems. Common things we see include sepsis, pneumonia, general infections, chest pain, abnormal heart rhythms, strokes, heart attacks, headaches and blood clots.

“Our patients are usually those who go see their GP and say, for example, they have a chest pain. It’s not clear at that point what’s going on but the GP thinks it just isn’t right and rather than send them to A&E, they come to AMU.

“Other patients are people who come to A&E but are sent to us because there is not enough time to undertake full investigations and treatment within the A&E’s four hour timeframe.”

The unit which has 21 beds and four admission trolleys is open 24/7, 365 days a year. There are plans to redesign the unit and triple the admission trolleys up to 12 spaces.

“It is one area where we can colocate resource, staff and space,” Dr Henderson says.

“Our aim is to see people as quickly as possible and get all of their tests done. We have access to any tests and try to do them within six to eight hours of the patient arriving.

“Patients are also reviewed by a consultant within six to eight hours and we then make a decision whether you can go home or need to stay for a short while or if you have a clear medical problem such as a heart attack, you go to that specialist area, which would be cardiology.

“A third of patients go home without an overnight stay.”

The unit sees patients aged from 16 upwards with a 106-year-old being the eldest patient to receive treatment in recent years. The aim is for patients to stay on the unit up to 24 hours, however in practice people may stay longer.

“Normally we have eight nurses and anything from between two and eight doctors on duty depending on the busiest times of day and week,” Dr Henderson says.

“There’s a peak in demand for us on Friday evenings but demand also significantly peaks everyday between 3pm and 7pm.

“You tend to find people wake up in the morning and feel a bit groggy, they see how they get on and then get a lunchtime emergency appointment with a GP who sends them to us - 50 per cent of our patients are referred in a narrow lunchtime window and they start arriving between 3pm and 7pm.

“Sunday nights are often busy but smoothing out the admission process is one of our major challenges to becoming more efficient.”

Dr Henderson who has been a consultant at SDH since 2009 trained at Cardiff University after being told by his teacher that his dreams of becoming a celebrated guitar player were never going to happen.

“My head of sixth form in Surrey took me aside and said that I needed to get a proper job,” he said. “She encouraged me to do medicine and it was the right decision. It’s a challenge.

It’s about seeing people at their most vulnerable and having the ability to speak with patients, get the right information and make decisions quickly before reassuring them there’s nothing wrong or if there is, then starting treatment early on. I’ve been in it eight to 10 years and it still gives me a buzz.

“The NHS is in challenging times. None of our lives have got any easier over the last 18 months and it will continue to get more difficult but it’s still about seeing people when they come through the door.”

For anyone thinking of a career in AMU, Dr Henderson says staff need a broad general medical knowledge, compassion and energy.

“It’s a very general area. It not’s like coronary care or ITU. You might be dealing with heart failure, gout or sepsis.

“People are as ill as they can be and frightened so that ability to keep smiling is important. Lastly, it’s busy. There’s no sitting down and you need to think quickly.

“SDH has got a good reputation and it still remains the friendliest place I have ever worked.”