Provision of medical same day emergency care services within the UK: analysis from the Society for Acute Medicine Benchmarking Audit
Atkin, Catherine Perrett, Madeleine Cooksley, Tim Varia, Ragit Holland, Mark Knight, Thomas Subbe, Christian Lasserson, Daniel S Sapey, Elizabeth
Atkin, Catherine
Perrett, Madeleine
Cooksley, Tim
Varia, Ragit
Holland, Mark
Knight, Thomas
Subbe, Christian
Lasserson, Daniel S
Sapey, Elizabeth
Affiliation
University of Birmingham; University Hospitals Birmingham NHS Foundation Trust; Manchester University NHS Foundation Trust; The Christie NHS Foundation Trust; Mersey and West Lancashire Teaching Hospitals NHS Trust; University of Bolton; Bangor University; Ysbyty Gwynedd; University of Warwick; Oxford University Hospitals NHS Foundation Trust
Other Contributors
Publication date
2025-04-22
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Aim: 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.
Citation
Atkin C, Perrett M, Cooksley T, Varia R, Holland M, Knight T, Subbe C, Lasserson DS, Sapey E. Provision of medical same day emergency care services within the UK: analysis from the Society for Acute Medicine Benchmarking Audit. BMJ Open. 2025 Apr 22;15(4):e094580. doi: 10.1136/bmjopen-2024-094580.
Type
Article