Clin Med
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Bed availability remains the main operational focus for managers and clinicians on a day-to-day basis within the NHS. There is now published research that establishes a lack of bed stock is too simplistic an explanation of the situation. ⋯ So far most of what little work has been done has focused on the front end of the process, to 'buffer' unplanned admissions through the use of short-stay facilities, such as medical assessment units, as a short-term solution. This paper reviews the evidence for the hypothesis that bed availability problems can be solved by actions other than the addition of more beds to the system.
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Patients with ALF or ACLF frequently develop multiple organ failure and should be managed by senior physicians in a high dependency or intensive care environment (Table 4).
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Clinical ethics committees (CECs) are increasing in number in the UK and have mostly developed in response to local interest, as opposed to being mandated as in the USA. However, there is no regulatory framework for UK CECs with no defined educational requirements or specification of core competencies for their members. ⋯ Recommendations for educational and membership requirements for CECs have also been made. Given the appropriate resources the standards proposed can be appropriately evaluated and are consistent with principles of ethical governance.