Abstract
Unscheduled admissions to hospital are usually coordinated by the acute assessment unit (AAU), often led in rotation by physicians from range of specialties, together with specialists in acute medicine. This hybrid model is a vestige since before the specialty of acute medicine was developed. The increasing elderly population means this needs to change, enabling elderly care physicians to work in parallel with acute physicians as the needs of patients in the AAU are largely served by these two disciplines. Specialties, including elderly care, should provide support by looking after patients with diseases in which they are expert, and by ensuring that the same specialist team looks after patients in the AAU and on downstream specialty wards. A major expansion in elderly care, and new ways of teamworking are required. A model of care is proposed.