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Ambulatory Emergency Care could prevent 14000 hospital stays this winter with investment

More widespread use of same-day emergency clinics could save at least 14,000 overnight hospital stays, a medical society has suggested.

The Society for Acute Medicine (SAM) has called on the government and NHS leaders to “realise urgently” the potential of ambulatory emergency care (AEC).

The service, which sits within acute medical units, offers an alternative to hospital admission for patients with serious medical problems who might otherwise have spent at least one night in a hospital bed.

In its report, called Winter 2018/19 in the NHS: The solutions, it says there are about 20 conditions, such as life-threatening blood clots (deep vein thrombosis), dislodged blood clots (pulmonary embolism), cellulitis, seizures and anaemia, suitable for treatment in this outpatient-based setting.

In a recent audit, which covered 127 acute medical units and 6,114 patients over a 24-hour period in June, SAM found only 20.1% of patients received their first assessment in AEC and, of these, 79.5% returned home the same day – saving 977 overnight bed stays.

SAM president Dr Nick Scriven said that just a 5% increase in the number of patients who receive their first assessment and subsequent treatment in AEC could save an additional 238 overnight bed stays – which would equate to 14,042 overnight admissions over January and February.

Scriven 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.

“From our projections, just a 5% increase in the number of emergency patients being seen in AEC could save at least 14,000 overnight beds days across the busiest winter months.”

Dr Taj Hassan, President of the Royal College of Emergency Medicine added: “Patients quite naturally want to be back in their own homes as quickly as possible, and AEC is a good way of enabling this where appropriate.

“Not only is it good for the patient but also the hospital as it helps reduce unnecessary admissions, increases safety and improves flow.

“But let’s be clear, such measures will not prove to be a silver bullet for the problems we face. These measures are ones that can be taken to lessen the impact of winter while systems await real action in the form of a credible 10-year plan and extra, sustainable funding for workforce planning, acute hospital beds and social care.”

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