Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

Model of Care for Acute Surgery

The Model of Care for Acute Surgery defines the core principles on which an acute surgical service model should be built and the key strategies that underpin these principles.

Model of Care for Acute Surgery (PDF, 4.0MB)

Patients requiring acute surgical care constitute over 60% of the workload of many surgical departments. In addition these patients are frequently the sickest, are elderly and have considerable co-morbidities and poorer outcomes.

This Model of Care for Acute Surgery sets out best practice principles and strategies necessary to ensure the provision of high quality acute care for patients in Ireland. Adherence to these principles, strategies and underlying critical considerations is designed to ensure that the acute surgical patient experiences:

  • Safe, quality care in a suitable environment.
  • Appropriate and timely attention from a senior surgical decision maker working within a dedicated multidisciplinary team.
  • Prompt diagnosis, appropriate treatment and, where necessary, timely surgery and discharge.
  • Effective communication and respect for their autonomy and privacy.
  • An optimum outcome with good after care, support and follow up.

The document also sets out to provide a road map to inform the delivery of acute surgical care so that patient outcomes are optimised and maximum efficiencies, both clinical and process driven, are achieved. It addresses inter alia the following issues:

  • Generic and specialty specific standards of care.
  • The separation, where possible, of acute from elective stream.
  • A consultant-led service.
  • Hospital groups and networks recognising the need for appropriate and dedicated facilities.
  • How surgical teams (all disciplines) work and their governance.
  • Capacity planning.
  • Acute Surgical Assessment Units, where appropriate.
  • The importance of designated beds and theatres.
  • Working with other programmes in unscheduled care.

Throughout the two documents the importance of routinely collected data and key performance indicators (KPIs) are stressed. It emphasises the importance of metrics and enabling ICT tools to inform clinical decisions and policy making.

Model of Care for Acute Surgery (PDF, 4.0MB)

If you require additional information regarding the models of care, hospital site visits, surgical activity analysis, the Productive Operating Theatre (TPOT) or any of the tranches of the NCPS, please email us at