Plans to provide same day patient care has been ‘grossly derailed’ – medics warn

A plan to treat and discharge patients from hospital on the same day has been “grossly derailed”, senior medics have warned.

Under the NHS Long Term Plan, every hospital with a 24-hour emergency department is expected to provide a same day emergency care (SDEC) service at least 12 hours a day, seven days a week, by the end of 2019/20.

SDEC provides same day care for emergency patients who would otherwise be admitted to hospital.

It is for patients with conditions such as headaches, deep vein thrombosis, pulmonary embolism, pneumonia, cellulitis and diabetes, and means they can be rapidly assessed, diagnosed and treated without being admitted to a ward.

If it is safe to do so, the patients are discharged the same day.

But the Society for Acute Medicine (SAM) said its own research has found that 45% of SDEC units had their “functioning impaired” by hospital trusts using the space as overflow for admitted patients at times of high demand.

The latest data was collected in June and included figures for 141 units across the UK.

Dr Susan Crossland, president of the SAM, said: “For all its good intention, the NHS’s grand plan to use SDEC to improve care and capacity this winter has been grossly derailed as trusts scrounge for additional beds.

“This shows first-hand how the unsustainable reduction in bed numbers and lack of investment in adequate staffing over many years is severely affecting the ability of the NHS to deliver on promises such as this one.

“We strongly endorse and support the provision of these services if they are appropriately resourced and running properly, and we call for urgent action to ensure that happens.”

Dr Nick Scriven, immediate past president of the SAM, added: “We are increasingly concerned we will never see SDEC fully implemented as desired if units are constantly seen as the ‘easy’ target when under-pressure managers need extra bed space.

“Until the NHS can sort out its acute capacity and staffing levels, nothing will get better in this respect and that is not what anyone wants to hear as we move through January when pressures will ramp up further still.”

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