Care Pathways

21.11.18

More same-day emergency clinics ‘could cut down on 14,000 hospital stays’ during winter

Greater investment in same-day emergency clinics could save at least 14,000 overnight hospital stays during the months of January and February next year, making ambulatory emergency care (AEC) a potential solution to the looming winter period.

In a report released today, senior medics from the Society for Acute Medicine (SAM) called on the government and NHS leaders to urgently realise the potential of AEC and address why the implementation of these units is not yet “standard or uniform” across the country.

According to the report, same-day emergency clinics, which sit within acute medical units, offer an alternative to hospital admission for those with serious problems who might otherwise have spent at least one night in a hospital bed. There are around 20 conditions, for example – such as life-threatening blood clots, cellulitis, seizures, and anaemia – that are suitable for treatment in this outpatient setting.

Furthermore, a recent audit – which spanned 127 acute medical units and more than 6,000 patients over a 24-hour period in June – found that only 20% of patients received their first assessment in AEC and, of these, almost 80% returned home the same day. This saved almost 1,000 overnight bed stays.

Dr Nick Scriven, SAM president, said that an increase as small as 5% in the number of patients who receive their first assessment and subsequent treatment in AEC could save almost 250 overnight admissions – or over 14,000 if considering admissions across January and February, during the peak of wintry demand.

He said: “AEC has obvious benefits for the patient in that they usually remain in their own clothes, remain mobile and get to sleep in their own beds while, for the hospitals, it is a way of alleviating overnight bed pressures.

“Given how much pressure we are all under, it would seem reasonable to look at how much could be achieved with investment in this area.”

Today’s report follows warnings from SAM that the government’s £145m investment boost, which will help provide an extra 900 beds, fell 3,100 short of the number required last winter. Dr Scriven therefore urged the Department of Health and Social Care to look again at its investment in AEC and how much can be achieved by implementing same-day clinics.

“With winter rapidly approaching the NHS is on borrowed time. AEC would seem to be an area that is beneficial to both patients and the service but is variably used throughout the country,” he added. “To evoke maximum benefit, a significant investment and national plan for this area is required.”

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