Emergency hospital admissions in the UK have been rising steadily. Medical emergencies account for the largest proportion of unplanned admissions. Same Day Emergency Care (SDEC) is one of many ways the NHS are working to provide the right care, in the right place and at the right time. The national SDEC model builds on the previous work undertaken in ambulatory emergency care (AEC) services across the NHS, which was aimed at providing a consistent approach to patient pathways.

A proportion of medical admissions are suitable for SDEC, where they are assessed and treated, but do not require overnight admission to an inpatient bed. This is beneficial for patients, as hospital admission and its associated risks can be avoided. As inpatient admissions increase, it is also important to consider alternative methods of care to reduce pressure on inpatient services. SDEC is highlighted in the NHS Long Term Plan, recommending a third of patients in acute services should receive SDEC.

The number of medical patients receiving SDEC varies between centres. This may relate to local patient populations, but also local availability of services. SDEC is often delivered through Ambulatory Emergency Care, as well as the Acute Medical Unit, and multiple additional services can aid delivery, including hospital at home services, and early outpatient review in specialist clinics. These services vary between hospitals.

PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

EHR. UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: All patients admitted with unplanned medical admissions who receive Same Day Emergency Care from 2004 onwards. The dataset includes highly granular patient demographics & co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to acute care process (timings, staff grades, specialty review, wards), presenting complaint, acuity, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, imaging reports, all prescribed & administered treatments (fluids, blood products, procedures), all outcomes.

Available supplementary data: Matched controls ambulance, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement A.I. Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.