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Background: The UK is committed to achieve net zero greenhouse gas emissions by 2050. The suite of policies needed to reach net zero will lead to improvements in air quality and, consequently, could lessen air pollution inequalities. We assessed air pollution inequalities across different sociodemographic groups in England and Wales and explored how these might be differentially impacted by future air pollution projections in 2030 and 2040 under net zero policies., Methods: We employed a geodemographic classification approach to categorise neighbourhoods into five distinct clusters based on 2021 UK Census sociodemographic variables. We modelled fine particulate matter (PM 2.5 ) and nitrogen dioxide (NO 2 ) concentrations for the year 2019, and predicted concentrations in 2030 and 2040. We compared a business-as-usual (BAU) scenario and two policy pathways to achieve net zero currently considered by the UK government. We aggregated air pollution concentrations to the neighbourhood level and assessed differential neighbourhood-level concentrations across the geodemographic groups using descriptive statistics and box plots., Results: The Urban Central Professionals group experienced 14 µg/m 3 higher average NO 2 concentrations compared with the Rural Elderly group in 2019. Despite substantial improvements to air quality in 2030 and 2040 of up to 6.3 µg/m 3 for NO 2 based on BAU, and further reductions of up to 2.4 µg/m 3 NO 2 under net zero policies, the overall pattern of inequality persists, but is predicted to be less pronounced., Conclusions: Our findings demonstrate the effectiveness of targeted policies and innovations in reducing both air quality and greenhouse gas emissions and in bridging the environmental inequality gap. Our findings are essential to develop targeted communication campaigns to secure acceptance and willingness across the sociodemographic spectrum to support the significant behavioural changes needed to achieve net zero, by highlighting the wider co-benefits to the environment and health of such policies., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Co-authors Heather Walton and Mike Holland declare membership of the Committee on the Medical Effects of Air Pollutants reporting to the UK Department for Health and Social Care. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper]., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Early consultant review has been shown to improve outcomes in patients presenting to the Acute Medical Unit (AMU). The Society for Acute Medicine (SAM) clinical quality indicators use the time of arrival on the AMU for target rather than arrival in the Emergency Department (ED) although this is where most acute medical patients present., Aim: To determine the effect of a 7-day Consultant Acute Physician model on patient waiting times and assess the impact of starting the clock for medical patients at time of ED arrival., Design: We performed an audit at a University Hospital AMU in the North West of England., Methods: Data were collected prospectively for 15 consecutive days in May-June 2013 for all patients presenting to the AMU at University Hospital of South Manchester and were repeated for the same time period in 2014 following the introduction of a new Consultant working model., Results: Four hundred and five patients were admitted to the AMU in the 2013 cohort compared to 456 in the 2014 cohort. There was a significant improvement in the median waiting time for Consultant review from AMU admission to 5 h 53 min from 8 h 15 min (P < 0.001). The compliance with the SAM quality indicator for Consultant review improved from 88.7 to 93.7% (P = 0.022)., Conclusion: A 7-day Acute Physician working model is improving performance with regards to patient waiting times. We suggest that starting the clock for acute medical patients in the ED is a better measure of performance than on arrival to the AMU., (© The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

The burden of cancer is increasing, with a significant increase in cancer-related emergencies and patients with known malignancy presenting to the acute medical unit (AMU). We performed a retrospective analysis at a university hospital in the north west of England in May 2011. We examined 300 consecutive admissions to determine the number of, and reason for, cancer patients presenting to the AMU. Patients with cancer had a statistically significantly longer average length of inpatient stay than patients without cancer (8.8 days vs 7.2 days, p<0.01). As the incidence and prevalence of cancer increases, the challenge of improving the experience, safety and outcomes of patients with cancer becomes more important. Development of successful acute oncology services with close working with acute physicians will be essential in order to achieve this.