6. AMBULATORY CARE - WHAT IS IT?

The term "Ambulatory Care" was first coined in the US to describe any treatment in which the patient could be admitted and discharged within a working day. It has since then been picked up in the UK as a convenient umbrella term to cover out-patients, x-ray, day surgery and medical diagnostic services.

When people talk about an Ambulatory Care Centre they mean a building and service which are designed around the needs of the patient. Bringing services and skills to the patient in a well scheduled way, rather than the patient having to wander from one hospital department to another or having to come back on another day to get this or that test done.

Efficient design of building, equipment and working systems is key to success. Good design and good systems make it far easier to provide ‘one stop clinics’ and "walk in, walk out" treatments.

With so much non-emergency work now being done on a day case basis, Ambulatory Care Centres allow such work to be kept well separate from the demands of emergency services. (When the two use the same facilities, emergency work takes priority and so non-emergency patients experience delay and inconvenience).

It is already the case that the vast majority of patient experiences in Glasgow adult acute hospitals are ambulatory care. In a year, patient experiences of Glasgow adult acute hospitals have a strong ambulatory care pattern:

  No.  %
Attending Out-patient clinics 989,593 43
Attending imaging, EEG, ECG, audiometry as out-patients  443,931 19
Attending for physio, occupational therapy, speech therapy, dietetics, surgical appliances and hearing aids as out-patients. 284,412 12
Day cases 88,434 4
Ambulatory care excluding A & E  1,806,370 (78)
A & E attendances * 297,777 13
Acute hospital in-patient cases ** 198,469 9
TOTAL 2,302,616 100
 

* Approximately 75% of A & E attendances go home without being admitted to hospital. A & E attendances currently include emergency referrals from GPs.

** The acute hospital cases include emergency admissions via A & E – so approximately 75,000 cases are double-counted in the table above.

Figures exclude radiotherapy attendances.

Source: Scottish Health Service Costs, year ended 31st March, 1999.


We are proposing purpose-built state of the art Ambulatory Care Centres at Stobhill and the Victoria Infirmary. Sometimes you will hear these described as "ACAD units" which is NHS jargon for "Ambulatory Care and Diagnostic Units".

If you want to know more about Ambulatory Care Centres, there is a reference to it in "Acute Services – Review Report" published by the Scottish Office in May, 1998 (pages 51\52). The Health Service Journal published a Special Report on Ambulatory Care on 10th June, 1999.

There is other information about what we are proposing for the modernisation of Glasgow’s Acute Hospitals.

For a list of available on-line and printed leaflets, click here.

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