As A&E departments struggle to meet government targets, innovative palliative care approaches, where appropriate, not only provide better patient care but also less log-jam in A&E.
Accident and Emergency (A&E) waiting times have experienced a recent increase causing the NHS to consistently miss waiting time targets. 
In Scotland, the government target for A&E waiting times within 4 hours is 98% of those who arrive in A&E. The target measures the time from arrival to being discharged, admitted to hospital or transferred elsewhere.
Percentage of A&E patients arriving and being admitted, discharged or transferred within 4 hours in Scotland
Average waiting time statistics based on figures from ISD Scotland. 
For patients with end of life conditions, specialist palliative care services could streamline symptom control and expedite appropriate further care. Specialist palliative care units can help to provide this special attention.
The Acute Palliative Care Unit in Ninewells Hospital, Dundee, is a short-stay, intensive palliative care unit, which offers patients with advanced illness the possibility of rapid, multidisciplinary assessment. Where possible, patients can be transferred back into the community with:
- improved symptom control;
- a clearer understanding of where patients are in their illness; and
- co-ordinated community / hospital care.
PATCH was inspired by the model of care developed in the Acute Palliative Care Unit in Ninewells Hospital, Dundee. This model of care was started by a charitable donation to NHS Tayside Endowment Fund and is now funded by NHS Tayside.
- Levack, P. “Ninewells Acute Palliative Care & Symptom Control Unit - Report of the 2009/10 pilot” (PDF)
- Paterson,F. et al. (2012) “Short-stay specialist beds in a UK teaching hospital as a model to integrate palliative care into the acute hospital culture”, The Journal of the Royal College of Physicians of Edinburgh (42), p.8–14 (PDF)
- Taylor, A. et al. “The Effectiveness of an Acute Palliative Care Unit (APCU)”, presentation (PDF)