Date published: 6 August, 2026
Date last updated: 6 August, 2026
Urgent and emergency care

Reporting same day emergency care activity in the admitted patient care data set

Background

Same day emergency care (SDEC) is a core part of a high quality urgent and emergency care pathway, enabling patients to be treated and discharged on the same day.

Sites report SDEC activity inconsistently, making it difficult to accurately measure how much takes place across the NHS or properly assess its impact.

In response to concerns raised by providers about reporting specialty SDEC through the emergency care dataset, reporting will now be done through the admitted patient care commissioning data set (APC CDS). This is a permanent change.

This guidance refers to specialty SDEC units and activity only, which are same day emergency care services delivered by inpatient medical and surgical specialties, including acute medicine. Extended emergency medicine ambulatory care (EEMAC) services, sometimes referred to as ‘emergency medicine department same day emergency care’ are delivered by emergency medicine teams. EEMAC services will be reported via the emergency care data collection (ECDS) to align with other emergency department (ED) and emergency medicine activity.

What is a specialty SDEC?

SDEC is the provision of same day specialist care for patients who would otherwise require an overnight admission to an inpatient bed. Under this care model, patients can be rapidly assessed, diagnosed, treated and followed up in an allocated SDEC setting and go home on the same day. 

Specialty SDEC activity is delivered in designated ‘same day’ environments with access to the same diagnostics and treatment, and at the same speed, as EDs. SDECs should be open a minimum of 12 hours a day, 7 days a week. Patients should spend no more than 8 hours in the SDEC setting.

SDEC units have 4 different activity types, set out below, which need to be counted and coded to map the patient journey.

1. First SDEC episode

An unplanned urgent or emergency presentation for care for a new condition or deterioration of an existing one. Episode will include senior assessment, diagnosis and treatment. Episode will include at least 1 intervention. The patient may have attended an A&E (ED or Urgent Treatment Centre) prior to the SDEC, been streamed to SDEC without having attended A&E or been directly referred to SDEC from a healthcare professional in the community (including paramedics, Single Point of Access (SPOA), Urgent Community Response).

2. Deferred first SDEC episode

An urgent presentation for care for a new condition or deterioration of an existing one that can be managed in a semi-planned way. Episode will include at least 1 intervention. The patient may have attended an A&E (ED or Urgent Treatment Centre) prior to SDEC, been streamed to SDEC without having attended A&E or been directly referred to SDEC from a healthcare professional in the community (including paramedic, SPOA, Urgent Community Response).

An episode is deferred as it has been arranged in response to an initial presentation within the last 24 hours. If the episode falls outside the first 24 hours since initial presentation, it is planned, elective care, not urgent or emergency care.

3. SDEC follow-up

A planned (scheduled) face-to-face attendance following a first SDEC episode or deferred first SDEC episode for the same condition. This takes place within 7 days of the initial presentation for urgent or emergency or the first SDEC episode, whichever is later. Episode will include at least 1 intervention.

4. Virtual SDEC follow-up

A planned (scheduled) non-face-to-face encounter (telephone, video) following a first SDEC episode or deferred first SDEC episode for the same condition. This takes place within 7 days of the initial presentation for urgent or emergency or the first SDEC episode.

SDEC spells should be completed within 7 days of the initial presentation.

Recording specialty SDEC activity

Recording first specialty SDEC episodes

For emergency presentations (where a patient’s care needs cannot be deferred beyond 24 hours), specialty SDEC activity should be recorded as part of Admitted Patient Care Finished General Episode (CDS Type 130) within the admitted patient care commissioning data set:

Ward code is the identifier for specialty SDEC activity. Providers must notify NHS England of the ward codes allocated to their SDEC settings and give advance notice of any changes to those codes (see Next steps for providers).

The same approach applies to deferred first SDEC episodes where the decided to admit date may precede the attendance by up to 24 hours.

Recording specialty SDEC follow-up activity for ongoing treatment

Patients may return to a specialty SDEC unit for 1 or more procedures following their initial specialty SDEC contact. This scheduled activity should be reported as part of Admitted Patient Care Finished General Episode (CDS Type 130) within the admitted patient care commissioning data set:

Follow-up specialty SDEC activity should not be allocated a patient classification of ‘2: Day case admission’ so it can be distinguished from elective day case activity.

Recording specialty SDEC follow-up activity for review (including virtual consultations)

Patients may have 1 or more follow-up in-person or virtual consultations with the specialty SDEC service as part of their ongoing care, similar to a post-treatment follow-up outpatient consultation. This scheduled activity should be reported within the outpatient commissioning data set (Type 020) as follows:

Clinic code is the identifier for specialty SDEC activity. Providers must notify NHS England of the clinic codes allocated to their specialty SDEC settings and give advance notice of any changes to those codes (see Next steps for providers).

General principles for reporting specialty SDEC activities within the commissioning data sets

Location group (at ward stay) is a required data group as part of CDS6.3. Although ward code is an optional field, as it’s a local identifier, providers should routinely submit it. For patient safety reasons, providers should capture start and end dates / times for ward stays and include these in their commissioning data set submissions. 

Summary Hospital-level Mortality Indicator (SHMI)

Trusts record SDEC activity in different ways. Where trusts submit SDEC activity through the outpatient or emergency care data set (ECDS) rather than the admitted patient care (APC) dataset – or record it as day cases or regular day or night attenders within APC data – those records will not be included in the Summary Hospital-level Mortality Indicator (SHMI).

Because SHMI is calculated using APC data, changes to how trusts submit SDEC activity could affect their SHMI value. This is unlikely to cause significant changes to SHMI banding, although a small number of trusts may move band. The impact will vary between trusts depending on how they currently record and submit SDEC activity.

As all trusts are expected to transition to recording SDEC activity as admitted patients, the data will become more comparable over time and the impact on SHMI will reduce. SHMI scores are based on a rolling 12 months of data, so it will typically take 12 months from a trust changing its submission method before its score is directly comparable with trusts already recording SDEC this way. And because the SHMI models use a rolling 36-month dataset, there may be some impact on the overall range of SHMI scores until all trusts have been submitting consistently for 36 months.

Specialty SDEC payments

A new guide price for specialty SDEC was introduced in the 2026/27 NHS Payment Scheme. In the consultation on the scheme, it was proposed as a mandatory unit price. However, following consultation feedback – which raised concerns about inconsistent recording practices across the country and the range of patient care currently coded as SDEC – this was changed in the final scheme and the guide price is not mandatory. Providers and commissioners should use it to agree local prices for specialty SDEC as part of the urgent and emergency care blended payment for 2026/27. It does not apply to specialty SDEC follow-up or extended emergency medicine ambulatory care activity.

By separating emergency medicine-delivered and specialty-delivered SDEC, and establishing a consistent methodology for all trusts to report specialty SDEC activity, the quality of cost collection and attribution data will improve. This will make it possible to develop specialty SDEC prices that appropriately incentivise and reimburse same day care.

Next steps

All trusts must comply with this guidance by 1 April 2027 and make any necessary changes to their reporting as soon as possible. This includes ensuring the relevant ward codes for specialty SDEC facilities are included in their admitted patient care commissioning data set submissions.

The SDEC pages on NHS Futures will be updated with supporting information, including guidance on how providers should notify NHS England of the ward codes used for specialty SDEC facilities. Frequently asked questions will be answered on the SDEC forum, but if this section does not answer a question, please direct people to England.SDEC@nhs.net.

Publication reference: PRN02606

Date published: 6 August, 2026
Date last updated: 6 August, 2026