New 24/7 emergency unit treats patients referred directly by their GP, avoiding unnecessary A&E visits

A new Same Day Emergency Care (SDEC) Unit was officially opened on Tuesday 19 July 2022 at Warrington and Halton Teaching Hospitals NHS Foundation Trust, with the aim of reducing unnecessary admissions.

The combined medical and surgical unit operates 24/7 with a dedicated team that can assess, diagnose and treat patients referred directly from primary care or identified at the point of triage in the emergency department.

The extended space includes a triage facility, twelve assessment spaces and three treatment rooms for medical and surgical patients, meeting the defined criteria.

Historically, referrals from primary care into hospital were often time-consuming for staff on both sides and resulted in many patients being directed to the emergency department when they could have been treated elsewhere.

The leadership team at the SDEC Unit designed a process that would enable GP practices to carry out an assessment on a patient and, should they meet the criteria, make an immediate electronic referral directly to the SDEC Unit. The patient can then attend the SDEC Unit directly without needing to be triaged by the emergency department.

In September 2022, a pilot was implemented with the support of primary care networks (PCNs) in Warrington and Halton, and any areas for improvement were identified, discussed and actioned on a weekly basis as part of a Plan, Do, Study, Act (PDSA) model for improvement.

Upon a comprehensive review of the successful pilot, for both the trust and PCNs, data analysis showed that only 1 in 10 referrals received were deemed inappropriate, and the decision was made to formally implement the primary care referral process across all seven PCNs (41 GP practices) across Warrington and Halton in November 2022.

Monthly strategic and operational meetings continue to take place between the trust and key partners to ensure efficiency and improvements are continually being realised.