WHITHER THE ACUTE MEDICAL PATIENT

The continual change in NHS structure demands reappraisal of both the services provided and the allocation of resources to ensure appropriat e standards of care. Unfortunately this equation never seems to balanc e. Although the overall goal is to have an excellent standard of care, the necessary resources nearly always are lacking. As a consequence ' 'we'' often have to critically analyse and change clinical practice to achieve this goal. Nowhere in medicine is this point more pertinent t han in the management of acute medical emergencies. This article exami nes not only how the changing face of medicine influences this situati on but also possible solutions to the question who will manage these p atients in the future.