Same Day Emergency Care

Diagnostic code set for Same Day Emergency Care  

In 2019, NHS England instructed every major hospital in England to provide Same Day Emergency Care (SDEC) – (previously known as ambulatory emergency care). SDEC is the provision of unscheduled care for emergency patients who would otherwise be admitted to hospital. Under this care model, patients presenting at hospital with relevant conditions are rapidly assessed, diagnosed and treated by emergency medicine or inpatient specialties. Expert input from nursing, occupational therapy, physiotherapy and pharmacy is particularly important in this patient group who are often older patients and / or frail. Recording diagnostic activity in SDEC settings in an accurate and consistent way is essential for the provision and improvement of such services. 

The Faculty of Clinical Informatics (FCI) was commissioned by NHS Digital and NHS England to carry out a consultation on a national diagnostic code set for use in SDEC services. The proposed SDEC national diagnostic code set called ECDS-Max was derived from the Emergency Care Data Set (ECDS) diagnosis list (ECDS-Core) implemented in 2017 in Emergency Departments in England. Following the consultation and subsequent production of an Information Standards Notice (ISN), it is now being implemented in the NHS as ECDSv4.  

The consultation was carried out with SDEC and other hospital specialties and with industry. The findings and recommendations are included in a final draft report, together with the agreed version of both the ECDS-Core and ECDS-Max code sets.  The report finds that ECDS-Max contains sufficient detail and is fit for purpose in its current form and recommends that it should be implemented in SDEC to record diagnoses.  It further recommends that the process and editorial guidance for the curation of the ECDS-Max terms should be used for future expansion of the code set into hospital inpatient and outpatient settings for diagnosis recording.

Download the report and code by visiting NHS Futures website here