Great strides have been made in same day emergency care across the NHS over the last few years and the Ambulatory Emergency Care Network has played an important part in supporting organisations to achieve sustainable changes within their systems.

A number of pioneering trusts in the AEC Network have taken ambulatory emergency care a step further and created surgical AEC services. Due to the continued interest in Surgical AEC we felt that the next logical step to support trusts would be to establish a Surgical Ambulatory Emergency Care Network (SAEC), and we continue to work collaboratively with the British Association of Day Surgery who have a wealth of knowledge and experience in establishing same day services.

The premise behind SAEC is to provide safe and effective ambulatory care for a proportion of emergency general surgical “take” referrals. The SAEC pathway should provide streamlined efficient assessment, investigation and treatment (including surgery) avoiding delays in the patient journey through the hospital system. The expectation is a good service should avoid unnecessary steps, delays and duplication that add no value to patient care. The SAEC pathway must be safe with robust mechanisms where failure of ambulant care is rapidly recognised and patient care converted to traditional in-patient management as needed. A conversion rate from SAEC management to admission is seen in approximately 10-15% of patients and is considered illustrative of an SAEC which is safe with robust systems in place.

The Bath Model, shown in the image below, is a Consultant Led service with dedicated diagnostics, its own operating theatres and all supported by a virtual ward. 

                  

Current Directory Conditions

 Further details about the current surgical conditions can be found in the directory.  If you would like to see other conditions in the next edition please email us at aec@nhselect.org.uk 

So Where Do You Start?

Here are some suggested procedures as a starting point:

  • Appendectomy (laparoscopic)
  • Arthroscopy
  • Biopsy - lymph node; temporal artery
  • Evacuation retained products of conception
  • Incarcerated Hernia - inguinal; para-umbilical; femoral
  • Renal Colic
  • Incision and Drainage of Abscess - axillary; groin; neck; perianal; pilonidal
  • K-wiring
  • Laparoscopic ovarian cystectomy
  • Reduction and internal fixation
  • Tendon repair
  • Laparoscopic cholecystectomy