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What is Same Day Emergency Care (SDEC) and how does it link with Ambulatory Emergency Care services?

Same Day Emergency Care (SDEC)

an umbrella term for the units who see patients on a same day basis

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Ambulatory Emergency Care Unit (AECU)
(WPH & FPH) 

Surgical Emergency Unit (SEU)
(WPH & FPH)

Urgent Gynaecology Care Centre (UGCC)
(WPH & FPH)

Paediatric Assessment Unit (PAU)
(WPH & FPH)

These Same Day Emergency Care (SDEC) services aim to see and treat patients who would have previously been admitted by providing rapid clinical assessment, diagnostic service and treatment targeted at attempting to discharge patients the same day, avoiding the need for any unnecessary overnight stay.

To discuss the units in more detail, please contact:

Sean Harding, Consultant Nurse Acute Care: s.harding@nhs.net

FPH SDEC

FRIMLEY PARK HOSPITAL (FPH) – FRIMLEY SOUTH

 

Speciality

Name of unit

Days / times available

Contact details

Further guidance on how to access or use service

Acceptance / inclusion criteria

MEDICINE (FPH)

Ambulatory Emergency Care Unit (AECU) Frimley Park

 

Mon – Fri:

08:00 - 20:00

 

Location: through the main entrance and follow signs to the green zone (opposite the acute medical unit)

0300 613 3290

 

(Outside of these hours contact the on-call medical registrar available through switchboard - 0300 614 5000).

ALL referrals to Acute Medicine & Ambulatory Emergency Care between 08:00-20:00 should go via this referral line (0300 613 3290). After Acceptance, please complete the referral form available on DXS under 'ED and Urgent Care' Landing Page.

 

Senior medical presence cannot always be guaranteed on the unit, calls asking for the Med Reg for advice should still go through switchboard to bleep them as the unit is unable to transfer the call.

 

 

** PLEASE NOTE - This is not a walk-in service – please ensure you phone the referral telephone lines in the first instance.  

This phoneline takes ALL referral calls to acute medicine and will decide if appropriate for ED or AECU. Please see below AECU inclusion/exclusion criteria

AECU Inclusion Criteria:

All medical conditions will be considered for referral. If uncertain whether a patient is suitable for referral, discuss the case with the AECU / Medical team (Registrar or Consultant).

AECU Exclusion Criteria:

· Any patient presenting with a time critical condition, requiring immediate treatment upon arrival at hospital, MUST continue to be pre-alerted to ED.
· Any patient with suspected (or confirmed) Covid-19 symptoms e.g. 'Flu-like’ illness; New onset dry, persistent cough; Fever.
·Any patient presenting with a frailty syndrome should be referred via the Community Frailty Assessment Pathway.
· Abdominal pain.
· Active cardiac chest pain with or without ECG changes.
· Active diarrhoea.
· Active PR bleed.
· Lower Back pain.
· Complications following a recent surgical procedure.
· Fall with suspicion of fractures, multiple fractures or c-spine tenderness.
· Head injury.
· Acute confusion or Mental health problems.
· Suspected Neutropenic sepsis.
· Pregnant patients presenting with PV bleeding or a condition best managed by maternity.
· Under 16 yrs old (or 16-17 yrs and known to the paediatric team).
· Urinary retention.
· Patients seen in an outpatient setting with a documented decision to admit by their speciality team.
· Any other presentation considered unsuitable for referral, by the AECU/medical team.

SURGERY(FPH)

Surgical Emergency Unit (SEU)

Open 7 days a week: 

07:00-21:00

 

GP referrals - 08:00-18:00 (if outside these hrs, pts. will be directed to ED).

SAU entrance is through entrance C

 

 

 

Referral Line staffed by: 1st contact Surgical SHO: 0300 613 3393 (Ext 133393).

If unavailable 2nd contact SpR: 0300 613 3737 (Ext 133737).

 

ALL Acute referrals to General Surgery should go via this number (0300 613 3393).

 

There is also a 24hr surgical helpline for patients:

07990 528 061.

The line is manned by the SEU nursing team to give advice to patients that have been an inpatient within the last 28 days about wounds, drains, medications etc. (excluding issues around future appointments, repeat prescriptions and sick / fit notes).

This phoneline takes ALL Acute referral calls for General Surgery and Urology and will decide if appropriate for ED or SEU. Please see below SEU inclusion/exclusion criteria.

SEU Inclusion Criteria:

General surgical and urology presentations.

SEU Exclusion Criteria:

· Acute Head injury (requiring neurological observations)
· Suspected AAA Ruptures/leaks (Unless ruled out by CT)
· Unstable Spinal Injury (requiring log rolling or brace)
· Orthopaedic, Gynaecology or Medical patients.
· Paediatrics (Children under 16 years)
· Elective admissions.
· Terminally ill patients (i.e. transfers from hospice)
· Patients with/or requiring epidurals/ PCA/ Nerve block.
· Patients on cardiac monitors.

If the Trust is under extreme pressure these patients will be individually assessed for suitability by the Emergency Surgical Team (EST) Consultant or Registrar)

If a patient is clinically unstable or no space in SEU then the patient will be booked to ED.

GYNAE (FPH)

Urgent Gynae Care Centre (UGCC)

(Previously known as: Early Pregnancy Unit (EPAU/EPU).

7 days a week

Mon - Sun:

08:00 - 20:00

 

Location: OPD4

0300 613 6418 (if there is any difficulty in contacting EPU/UGCC, please call 'on call SHO' on bleep 5061 or registrar on bleep 5566)

ALL acute referrals to Gynaecology should go via this number.

 

 

The service has been increased to provide a 7 day a week service. Previously known as Early Pregnancy Unit (EPAU/EPU).

 

**PLEASE NOTE – UGCC/EPAU/EPU are NOT Walk in Services, please ensure you call the team in the first instance.

This phoneline takes ALL Acute referral calls for Gynaecology and will decide if appropriate for ED or UGCC. Please see below UGCC inclusion/exclusion criteria.

Early Pregnancy

UGCC Inclusion Criteria:

· Up to 15+6 weeks. From 16 weeks onwards, please call Labour ward triage 0300 613 6418).
· Please do a urine pregnancy test and ensure patient is pregnant.
· If possible send Serum HCG and Serum Progesterone. This helps to speed up diagnosis and discharge.

Emergency gynaecology

UGCC Inclusion Criteria:

· Over 16 years of age.
· Any gynaecology related symptoms that need urgent management.
· Post operative patients up to 14 days with surgical related complications (not for suture removal)
· Only mobile and independent patients.
· Bleeding after recent pregnancy where retained products of conception is suspected.
· Acute Batholin’s abscess

UGCC Exclusion Criteria:

· Pregnancy more than 16 weeks – Please refer to labour ward triage.
· Haemodynamically unstable patients.
· Any suspected surgical or medical patients.
· Post-menopausal bleeding - Please refer to rapid access clinic.
· Any patient who is not mobile and independent and cannot sit unaided in a chair.

PAEDIATRICS (FPH)

Paediatric Admission Unit/Advice Line (PAU)

Mon – Fri:
09:00 - 18:00

Location: PAU

07881 352 600- (Outside of these times please ask for the Paediatric Registrar via Switchboard - 0300 614 5000 Bleep 5100).

 

Paediatric Advice and Urgent Referral Process Flow Diagram- July 2021

ALL Acute referrals to Paediatrics should go via this number. This phoneline takes ALL acute referral calls for Paediatrics and will decide if appropriate for ED or PAU. Please see below PAU inclusion/exclusion criteria

PAU Inclusion Criteria:

· All acute medical referrals of children and young people up to the age of 16 years will be considered for referral apart from the exceptions below. If uncertain whether a patient is suitable for referral, discuss the case via the contact numbers provided for advice.

PAU Exclusion Criteria:

· Any patient presenting with a time critical condition, requiring immediate treatment upon arrival at hospital, MUST continue to be pre-alerted to ED.
· Babies under 10 days of age with feeding difficulties or jaundice who are usually seen on Post Natal.
· Young people between 16-18 years with new diagnoses of diabetes or cancer, or who present with a problem related to a condition for which they are still under paediatric outpatients.
· However, if there is any doubt about if a PAU referral is appropriate then it should be discussed via the contact numbers.

OTHER FPH urgent care services can be found here: https://www.fhft.nhs.uk/gps/gp-centre/urgent-advice (including the Frailty details below):

 

FRAILTY (FPH)

 

Integrated Frailty Liaison Team at FPH

7 days a week:

Mon - Sun:

07.00 - 17.00

Integrated frailty liaison team coordinators - 07920 757 286

 

Email:fhft.frailtyteamfph@nhs.net

 

 

Please refer to speciality guidelines & pathways on DXS.

 

This phone line will take referrals for anyone >65 presenting with a frailty crisis and will decide if appropriate for ED or Frailty.

 

FRAILTY Inclusion criteria:

Patients aged over 65 years who score positively on the Frailty Indicator tool, with a Rockwood score of 5 and above, who present with the following frailty crisis:

  • Fall

  • Reduced mobility

  • Altered level of consciousness (new confusion)

  • Incontinence (new)

  • Lots of medication (>5)

 

FRAILTY Exclusion criteria:

  • Aged 65 or under

  • Single organ pathology with clear specialty need

  • Suspected patients with TIA/stroke

  • Chest pains /ACS

  • Head injury with LOC

  • Suspected fractured NOF/long bone fracture

  • Ischaemic Limb

WPH SDEC

WEXHAM PARK HOSPITAL (WPH) - FRIMLEY NORTH

 

Speciality

Name of unit

Days / times available

Contact details

Further guidance on how to access or use service

Acceptance / inclusion criteria

MEDICINE (WPH)

Ambulatory Emergency Care Unit (AECU) Wexham

 

Mon - Fri:

9.00 – 22.00

 

Wknds & BH:

9.00 - 21.00

 

Level 1, EAC (above ED)

07384 527 685 or via switchboard (0300 614 5000).


 

(Outside of these hours calls are taken by the site manager available through switchboard - 0300 614 5000 or on-call Med Reg via switchboard Blp 4724)

ALL referrals to Acute Medicine & Ambulatory Emergency Care between 09:00-22:00 Mon-Fri and 09:00-21:00 Wknds & BH need to go via the referral line (07384 527 685). After Acceptance, please complete the referral form available on DXS under ED and Urgent Care Landing Page

Senior medical presence cannot always be guaranteed on the unit. Calls asking for the Med Reg for advice should still go through switchboard to bleep them, as the unit is unable to transfer the call.

 

** PLEASE NOTE - This is not a walk-in service – please ensure you phone the referral telephone lines in the first instance.  

This phoneline takes ALL referral calls to acute medicine and will decide if appropriate for ED or AECU. Please see below AECU inclusion/Exclusion Criteria.

AECU Inclusion Criteria:

All medical conditions will be considered for referral. If uncertain whether a patient is suitable for referral, discuss the case with the AECU / Medical team (Registrar or Consultant available via the referral line if needed).

AECU Exclusion Criteria:

· Any patient presenting  with a time critical condition, requiring immediate treatment upon arrival at hospital, MUST continue to be pre-alerted to ED.
· Any patient with suspected (or confirmed) Covid-19 symptoms e.g. 'Flu-like illness; New onset dry, persistent cough; Fever.
· Any patient presenting with a frailty syndrome should be referred via the Community Frailty Assessment Pathway.
· Abdominal pain.
· Active cardiac chest pain with or without ECG changes.
· Active diarrhoea.
· Active PR bleed.
· Lower Back pain.
· Complications following a recent surgical procedure.
· Fall with suspicion of fractures, multiple fractures or c-spine tenderness.
· Head injury.
· Acute confusion or Mental health problems.
·Suspected Neutropenic sepsis.
· Pregnant patients presenting with PV bleeding or a condition best managed by maternity.
·Under 16 yrs old (or 16-17 yrs and known to the paediatric team).
·Urinary retention.
·Patients seen in an outpatient setting with a documented decision to admit by their speciality team.
·Any other presentation considered unsuitable for referral, by the AECU/medical team

 

SURGERY (WPH)

Ward 2 –Surgical Emergency Unit- SEU

Mon-Fri: 08:00-20:00

GP Referrals -08:00-18:00(if outside these hrs, pts. will be directed to ED)

Location: Ward 2

 

 

 

Advanced Clinical Practitioner:

07468 354436

(Outside these hours calls are taken by the Surgical SHO on-call Bleep 4422 via switchboard – 0300 614 5000).

 

ALL Acute referrals to General Surgery should go via this number

(07468 354436).

 

This phoneline takes ALL Acute referral calls for General Surgery and Urology and will decide if appropriate for ED or SEU. Please see below SEU inclusion/exclusion criteria

SEU Inclusion Criteria:

General Surgical and urology presentations. 

SEU Exclusion Criteria:

  • Acute Head Injury (requiring neurological observations)
  • Suspected AAA ruptures/leaks (unless ruled out by CT)
  • Unstable spinal injury(requiring log rolling or brace)
  • Orthopaedic, Gynaecology or Medical patients
  • Paediatrics (children under 16 years)
  • Elective admissions
  • Terminally ill patients (i.e. transfers from hospice)
  • Patients with/or requiring epidurals/PCA/nerve block
  • Patients on cardiac monitors

If the trust is under extreme pressure these patients will be individually assessed for suitability by the Emergency Surgical Team (EST) consultant or Registrar)

If the patient is clinically unstable or no space in SEU the patient will be booked into ED. 

GYNAE (WPH)

Urgent Gynae Care Centre (UGCC)

Previously known as: Early Pregnancy Unit (EPAU/EPU).

 

7 days a week:

Mon - Sun

08:00 - 20:00

 

Gynaecology Outpatients Department- Maternity building

0300 6154429

ALL Acute referrals to Gynaecology should go via this number

The service has been increased to provide a 7 day a week service.

**PLEASE NOTE – UGCC/EPAU/EPU are NOT Walk in Services, please ensure you call the team in the first instance.

This phoneline takes ALL Acute referral calls for Gynaecology and will decide if appropriate for ED or UGCC Please see below UGCC inclusion/exclusion criteria.

 

Early Pregnancy

UGCC Inclusion Criteria:

· Up to 15+6 weeks. From 16 weeks onwards, send to maternity assessment centre (MAC) (phone: Wexham Park- 0300 615 4520). 
· Please do a urine pregnancy test and ensure patient is pregnant. 
· If possible send Serum HCG and Serum Progesterone. This helps to speed up diagnosis and discharge.

Emergency gynaecology

UGCC Inclusion Criteria:

· Over 16 years of age.
· Any gynaecology related symptoms that need urgent management.
· Post operative patients up to 14 days with surgical related complications (not for suture removal)
· Only mobile, stable and independent patients.
· Bleeding after recent pregnancy where retained products of conception is suspected.
·Acute Batholin’s abscess

UGCC Exclusion Criteria:

· Pregnancy more than 16 weeks – Please refer to MAC.
· Haemodynamically unstable patients.
·Any suspected surgical or medical patients.
· Post-menopausal bleeding   - Please refer to rapid access clinic.
· Any patient who is not mobile and independent and cannot sit unaided in a chair.    

PAEDIATRICS (WPH)

Paediatric Admission Unit (PAU)/ Advice Line

Mon - Fri
09:00 -18:00

07919 175 643 (Outside of these times please ask for the Paediatric Registrar via Switchboard - 0300 614 5000 Bleep 4516).

 

Paediatric Advice and Urgent Referral Process Flow Diagram- July 2021

Acute referrals to Paediatrics should go via this number.

This phoneline takes ALL Acute referral calls for Paediatrics and will decide if appropriate for ED or PAU. Please see below PAU inclusion/exclusion criteria

PAU Inclusion Criteria:

· All acute medical referrals of children and young people up to the age of 16 years will be considered for referral apart from the exceptions below. If uncertain whether a patient is suitable for referral, discuss the case via the contact numbers provided for advice.

PAU Exclusion Criteria:

·Any patient presenting with a time critical condition, requiring immediate treatment upon arrival at hospital, MUST continue to be pre-alerted to ED.
· Babies under 10 days of age with feeding difficulties or jaundice who are usually seen on Post Natal.
· Young people between 16-18 years with new diagnoses of diabetes or cancer, or who present with a problem related to a condition for which they are still under paediatric outpatients.
· However, if there is any doubt about if a PAU referral is appropriate then it should be discussed via the contact numbers

OTHER WPH urgent care services can be found here: https://www.fhft.nhs.uk/gps/gp-centre/urgent-advice(including the Frailty details below):

 

FRAILTY (WPH)

Integrated Frailty Liaison Team

Mon - Sat:

07:30 - 18:00

Sun:

07:30 - 16:00

Consultant: 07787 275775

 

Email:fhft.frailtyteamwexham@nhs.net

All referrals should go via this number.

This phone line takes referral calls for anyone over 65 years and will decide whether appropriate for ED or Frailty team.


  • Patients aged over 65 years who score positively on the Frailty Indicator tool, with a Rockwood score of 5 and above:

  • Frail

  • Reduced mobility

  • Altered level of consciousness

  • Incontinence

  • Lots of medication

  • Patients aged over 65 years from a care home

  • Patients aged over 90 years with co-morbidities

 

Exclusion criteria

  • Aged 65 or under

  • Single organ pathology with clear specialty need*

  • Suspected patients with TIA/stroke

  • Chest pains /ACS

  • Head injury with LOC,

  • Suspected fractured NOF

  • Ischaemic Limb

ED FPH and WPH

 EMERGENCY DEPARTMENT (ED)

EMERGENCY DEPARTMENT (ED)

If you are referring to SDEC please ensure that you follow the appropriate referral process and if you direct to specialty, please ensure that the speciality has accepted the patient before sending them with a letter.

A referral form is now available on DXS for ED. This has been developed to improve communication between primary and secondary care and should follow a phone call being made to the specialist and not be instead of. It ensures patients being referred to hospital as an emergency have the relevant supporting documentation and ‘hand over’ from primary care colleagues.

The form can be found on DXS Landing Page “ED and URGENT CARE” or can be found by searching with the terms “FHFT ED”, “Emergency”.

The ED form has an option at the top for users to choose which site they would like to refer to and the respective email address for WPH or FPH, the form. This form can be emailed directly from DXS to the specified ED nhs.net inbox these inboxes are:

FPH: fhft.fphed@nhs.net

WPH: fhft.wphemergencydepartment@nhs.net

Minor Injury Care

Name of Service Location Days / time available Contact details Further guidance on how to access or use service Acceptance / Inclusion Criteria
Minor Injury Same Day Service (pilot) Bracknell Healthspace (Brants Bridge Address: Eastern Gate, Brants Bridge, Bracknell, RG12 9RT) This minor injury service is available:
Mon-Sun
08:00 to 20:00

X-ray access is available:
Mon - Fri and Sun (not available Saturday)
08:00 to 19:30

NB that the last accepted x-ray slot is 19:30, to allow for maintenance of the equipment prior to close.
The minor injury pathway is accessible via:

- NHS 111 Triage as a Booked appointment

- GP referral to the clinician in charge via 07773 018190

- Paramedic referral to the clinician in charge via 07773 018190

- Walk in from unheralded patients or those advised to attend without a booked appointment from 111 or GP practice

PLEASE NOTE THAT THE CLINICIAN PHONE NUMBER IS NOT FOR PUBLIC USE OR CIRCULATION - IT IS FOR CLINICIANS ONLY

This is a Minor Injury service only.

Patients with minor illness that attend will be assessed and redirected to their GP practice or pharmacy.

The minor injury service is led by specialist nurses with prescribing capability. The clinicians provide telephone and video consultations in addition to face to face.

The service accepts walk-ins, but if possible, please contact the clinician in charge via the mobile number 07773 018190 to support virtual management or a booked appointment.

 

 

 

 

 

 

 

 

 

 

 

 

 

Some common conditions or illnesses that can be treated at Bracknell Urgent Care Centre include: 

Sprains and strains

Suspected fractures and broken limbs

Minor head injuriesCuts and grazesBites and stings

Minor scalds and burns

Ear and throat infections

Skin infections and rashes

Eye problems

Coughs and colds

Feverish illness in adults

Feverish illness in children

Abdominal pain

Vomiting and diarrhoea

Emergency contraception

We are unable to see patients for the following:

Long standing medical conditions that are managed by a patient’s own GP

Dental problems

Sick notes/fit notes

Repeat prescriptions

Strong analgesia, benzodiazepines, antipsychotics, sleeping tablets or specialised medications prescribed by a consultant

Urgent Community Response/Frailty Virtual ward/Hospital at home- North and South

Information about The Urgent Community Response (UCR) service and the Frailty Ward is available on the following link: Frailty virtual ward | NHS Frimley Health Foundation Trust (fhft.nhs.uk).