Combined Assessment Unit (CAU)

The Combined assessment Unit  is based within the hospital where people are referred either by their GP, Out of Hours service, the Emergency Department or outpatient clinic for assessment of medical or surgical problems.

The purpose of the unit is to assess you as soon as possible to agree with you an appropriate plan to determine if you require in patient care or discharge.

This will depend on what treatment you require and how busy the Combined Assessment Unit is. Typically, 9 out of 10 people spend less than 48 hours in the unit.

3 in 10 people go home directly from the Combined Assessment Unit within 24 hours

1 in 10 people go home directly from the Combined Assessment Unit after a slightly longer stay

6 in 10 people require ongoing care elsewhere in the hospital


Once you have been assessed you may be:

  • discharged home
  • admitted
  • sent home and asked to return another day for further tests

You should bring your medications with you.

You may be in the unit for several hours before being fully assessed.

 You may wish to bring a book or tablet computer with you.

You will be assessed in the unit by a member of nursing staff where basic observations will be taken. Appropriate investigations will be organised if required.  Investigations such as a tracing of your heart (ECG), X-rays, scans and blood tests may be taken.  This is known as nurse triage.  If you are well enough you will be asked to sit in the waiting area.  Following this you will be assessed by a Nurse Practitioner or a doctor.

Visitors are welcome, especially during the initial assessment process to help us clarify the story.  We request that visitors are respectful of the hospital environment.

Access to the unit: Visitors and relatives can access the unit via the main entrance of the hospital, then head to the Combined Assessment Unit.

At night time, access is through the Emergency Department.

Welcome to the Combined Assessment Unit (CAU) – What to expect

You have been referred here for assessment of your medical or surgical issue.

CAU is made up of:

  • Nurse Triage Area
  • Waiting Area
  • Assessment Area
  • ‘Pod A’ – Surgical Assessment Area and Medical/Surgical beds
  • ‘Pods B, C, and D’ – Medical beds

The assessment process:

If you have been referred from the Emergency Department, you will already have had blood tests taken, and possibly a heart tracing (ECG) and X-ray.

If you are arriving from your GP Practice as a referral to the Surgical Team, you will be taken directly to the Surgical Assessment Area and reviewed by the Surgical Team.

If you are arriving from your GP Practice, treatment helpline or clinic as a referral to Medicine, you will go via the Nurse Triage Area where you will have:

 Vital Signs Check                  Blood tests                ECG                                                             

After this, patients who are well enough will be asked to sit in the waiting room, pending a space in the assessment area; this can take up to a few hours at busy times. You will be prioritised primarily by how unwell you are.

Investigations and Treatment:

Once in the assessment area, you will be seen by a doctor or Advanced Nurse Practitioner. They will speak to you, examine you, discuss any test results that may already be back, start initial treatment, and arrange any further investigations needed.

These investigations might take place the same day or for more complicated tests, on another day; if you are well enough, you can go home and return for these. Urgent tests will be carried out as soon as possible.

Your case will be reviewed by a Consultant who will discuss a plan, either the same or following day.

Daily ward rounds and reviews:

This process continues with daily ward rounds and reviews by the allied professionals such as Occupational therapy,
Physiotherapy and Pharmacy, until you are fit to return home, sometimes with extra assistance or plans for follow-up.

Around a quarter of patients can go home within 48 hours of arrival, but if we anticipate you may need a longer stay,  plans will be made to transfer you to an appropriate ward within the hospital.

Visiting information:

Visitors are welcome at any time, although we ask for large groups to be kept to a minimum. Ward rounds  occur in the morning, therefore afternoon and evening visits are likely to have fewer interruptions from hospital staff.

How to get information on relatives’ care:

Should you wish to gain information on your relatives’ care during their stay, please speak to one of the nursing staff who may be able to give an update. Please be aware the nursing staff have many duties and only short updates may be
possible. For further detail or discussion, please ask to speak to a doctor. If our junior team cannot answer your questions, consultants are available.  An appointment may need to be made either through their secretary or the CAU Charge Nurse.

It is better to speak to relatives face-to-face rather than over the telephone, for clarity and confidentiality reasons, so please aim to speak to staff directly if you are able to do so.

Discharge process:

On the day of discharge, we will aim to identify possible discharges in the morning, and make contact with appropriate family, carer and/or ambulance staff to arrange details.

If you want a copy of your discharge letter before leaving, or if there are changes to your medicines, you will need to wait for the letter to be completed and/or medicines to come from pharmacy. This can take a few hours, depending on CAU and Pharmacy pressures.

Please plan to assist travel home from midday.