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Internal Medicine as a speciality. One in four of us have two or more long-term conditions (LTCs), often known as ‘multimorbidity’ and this rises to two thirds of people aged 65 years or over. Care for people with multimorbidity is complicated because different conditions and their treatments often interact in complex ways. Despite this, the delivery of care for people with multiple long term conditions is still often built around the individual conditions, rather than the person as a whole. As a result, care is often fragmented and may not consider the combined impact of the conditions and their treatments on a person’s quality of life.

Greater specialisation, especially for hospital based doctors, has improved our ability to treat single diseases, but unless we react to the increase in multimorbidity it will disadvantage the increasing proportion of patients with multiple seemingly unrelated diseases. Patients may be transferred to specialty wards after they have been assessed, but as many people have a number of chronic conditions which do not neatly fit into one specialty. There is a need for physicians and nurses to be able to treat patients with a number of interacting conditions, and be skilled in delivering care to older people, who may have cognitive impairment and frailty. People over the age of 65 comprise about 15% of the population but account for 60% of acute hospital admissions. Skills in dealing with these patients need to be developed in all specialties.

In essence this is the speciality of Internal Medicine. Around the world there is a greater focus of this as a single specialty, recognising and valuing the benefit of teams with skills able to deal with multiple conditions. This service is about taking forward this crucial future focused skill set and will provide our patient population much better care.

Hartor and Hembury are our ‘Internal Medicine’ wards in the University Hospitals Plymouth NHS Trust. This means that the case mix of our patients will be matching that of the growing trend in patients coming through the emergency front door of the hospital. Our patients are often known as General Internal Medical (GiM) or Multi-morbidity conditions. We now have four excellent specialist consultants in Internal Medicine called Dr Renata Valdes De Leon, Dr Geraldine Quintero-Platt, Dr Roland Boey and Dr Mohamed Attia. We have one of UHP’s best Matron’s Natalie Howes and the most patient centred and caring ward sisters in Lin Satterly and Liz. The service is also led by our Clinical Director Dr Juan Acevedo and supported by the management team Kenny Naughton, Kat Roue and Marie Collicott.