Access to same day emergency care

Same day emergency care (SDEC) services are available in all major hospitals across the country. There are various ways to access SDEC, although this is not a walk-in service.

Patients can be directly referred to SDEC in different ways, either from a GP, a community response team, NHS 111, an ambulance, or via emergency departments (EDs).

Increasing direct referral from ambulance clinicians to SDEC

One of our aims for 2021/22 is to ensure access to SDEC services is available system-wide, whether that is in a hospital setting or within the community.

To support this, we have produced national guidance to help ambulance providers with designing and implementing direct referrals into SDEC.

The guidance sets out the key principles which need to be adopted when implementing direct referral pathways to SDEC. It also includes a situation, background, assessment, recommendation (SBAR) template to support decision making.

Action cards are also available for ambulance, and NHS 111 and Clinical Assessment Service (CAS) clinicians. These one-page guides provide practical advice and information on making direct referrals to SDEC.

Benefits of direct referral to SDEC

If SDEC is suitable, direct referrals into the service benefits patients in many ways.

Referring to SDEC at the earliest opportunity reduces any unnecessary clinical contact, and time spent in ED waiting rooms or other healthcare settings.

This allows patients to spend hours, rather than days, in hospital which improves their experience and benefits patient flow.

Direct referrals also help safely reduce avoidable conveyance to EDs, as ambulances can convey directly to SDEC services when required. This helps reduce ambulance handover times and ensures more hospital beds are available for patients needing admission for emergency care.

Patients who are deemed clinically appropriate for SDEC can be directly referred by the responsible clinician following a clinical conversation with the local service. These discussions will ensure SDEC services are ready to support care upon arrival.

Systems have been asked to maximise the utilisation of direct referrals to SDEC services in the 2021/22 operational planning guidance. This is also a key ambition of the NHS Long Term Plan.

The intention, ultimately, is to help reduce the impact on EDs and provide patients with a better experience of care, ensuring they are referred to the right service at the earliest opportunity.