Provision of medical same day emergency care services within the UK: analysis from the Society for Acute Medicine Benchmarking Audit

To evaluate the current provision of medical same day emergency care (SDEC) services within the UK, and the current utilisation of these pathways in the assessment of unplanned medical attendances.

Design

Survey data was used from the Society for Acute Medicine Benchmarking Audit (SAMBA), including anonymised patient-level data collected annually using a day of care survey.

Setting

Hospitals accepting unplanned medical attendances within the UK, 2019–2023.

Participants

34 948 unplanned and 4342 planned attendances across 188 hospital sites.

Results

29.8% of unplanned medical attendances received their initial medical assessment within SDEC services (2403 patients in SAMBA23), with the proportion increasing over time. 82.4% of patients assessed in SDEC services were discharged without overnight admission. Assessment in SDEC services was less likely in male patients, patients with frailty and older adults (all p<0.005).

Selected operational standards for SDEC delivery, set by the Society for Acute Medicine, were met in 64%–91% of hospitals. Most hospitals (82%) accepted referrals from emergency department triage and 63% accepted referrals directly from the paramedic team. 38% of hospitals did not use a recognised selection criteria to identify suitable patients for SDEC and only 8% used a criteria designed to identify patients suitable for discharge. Overall, 34.7% of medical attendances discharged without overnight admission received their medical assessment in locations other than SDEC.

Conclusions

Medical SDEC provides assessment for one-third of patients seen through acute medicine services. Although the proportion of patients assessed within SDEC is increasing, further innovation and improvements are needed to ensure appropriate patients access this service.