It aims to benefit both patients and the healthcare system by reducing waiting times and unnecessary hospital admissions.
What is same day emergency care?
SDEC is the provision of same day care for emergency patients who would otherwise be admitted to hospital.
Under this care model, patients presenting at hospital with relevant conditions can be rapidly assessed, diagnosed and treated without being admitted to a ward, and if clinically safe to do so, will go home the same day their care is provided.
When a patient comes to hospital, an SDEC service (which may operate under the name of ambulatory emergency care unit) means patients with some medical concerns can be assessed, diagnosed, treated and safely discharged home the same day, rather than being admitted.
SDEC services treat a wide range of common conditions including headaches, deep vein thrombosis, pulmonary embolus, pneumonia, cellulitis, and diabetes. The types of conditions that can be managed through SDEC will vary depending on the hospital and needs of the local population.
The national SDEC model builds on previous improvement work in ambulatory emergency care (AEC) services across the NHS, with the aim of providing a consistent approach to patient pathways.
How it works
Patients can be referred to SDEC treatment through a number of different ways, including:
- triage in emergency departments (EDs)
- direct referral from GPs
- direct transfer from ambulance
- direct referral from NHS111
Types of SDEC treatment include:
- acute medical SDEC
- surgical SDEC
- acute frailty
The ambitions from the NHS Long Term Plan note that all hospitals with a 24 hour ED (type 1) will provide:
- the provision of SDEC at least 12 hours a day, 7 days a week by September 2019 and by March 2020 for surgical SDEC
- an acute frailty service at least 70 hours a week by December 2019, with the aim to complete a clinical frailty assessment within 30 minutes of arrival in the ED/SDEC unit
- record all patient activity in EDs, urgent treatment centres and SDECs using same day emergency care data sets in April 2020.
Why is this good for patients?
There are significant benefits associated with treating people through SDEC services, including:
- the ability for patients to be assessed, diagnosed and start treatment on the same day, improving patient experience and reducing unnecessary admissions
- avoiding unplanned and longer than necessary stays in hospitals, resulting in lower risk of infections and de-conditioning for patients
- financial benefits and cost savings for hospitals, and often for patients too.
The SDEC programme produces a wide range of resources to support the implementation of SDEC across the NHS. These resources can be found below.
We also provide links to relevant resources produced by others to support sharing of knowledge across the system. The Ambulatory Emergency Care (AEC) Network website hosts a number of useful resources that can provide guidance and support to providers when implementing SDEC.
- Acute Frailty Network (AFN) – Supporting people with frailty and urgent care needs to get home sooner and healthier
- On Twitter you can use the hashtag #NHSSDEC if you would like to join the conversation.
- Commissioning for Quality and Innovation resources
- NHS England's urgent and emergency care section