• New data set will help unravel zero-day admissions confusion, says Mark England
  • Transitioning trusts has been like “herding rabid cats” says clinical lead
  • Cliff Mann calls for capital funding to help hospitals build ambulatory care units

Moving to new data standards will be “traumatic” for the NHS but is vital because “we are really struggling to measure and understand the activity at the front door of our hospitals,” a senior NHS England figure has said.

NHSE deputy national emergency care director Mark England urged trust leaders to buy into the on-going complex roll-out of the new emergency care data set, which the programme’s clinical lead said had been akin to “herding rabid cats”.

Every trust must be using the emergency care data set, which includes 108 items, this year for urgent treatment centres as well as accident and emergency departments. It was developed in partnership with the Royal College of Emergency Medicine.

The new data set, which has taken years to develop, will allow far more granular analysis of which patients are arriving at emergency departments and what treatment they are receiving.

It underpins a flagship target in the NHS long-term plan to “increase the proportion of acute admissions typically discharged on day of attendance from a fifth to a third”.

Speaking at the NHS Confederation conference breakout session yesterday, Mr England admitted moving to a “new way of counting ambulatory care” was proving “traumatic”. But he said it was critically important because “at the moment we really can’t explain or understand what’s happening at the front door of the hospital in sufficient detail”.

“That means we can’t recognise good day same day emergency care, we can’t reward it, [and] we can’t spot unwarranted variation,” he added.

Tom Hughes, clinical lead of the emergency care data set, said: “The real anxiety [at the moment] is that zero day admissions have been increasing 10 to 12 per cent [but] we are not able to see why that is.

Describing the transition so far, he said: “It’s not just herding cats. It’s herding rabid cats. There are 200 emergency departments [using] 40 odd software suppliers… We have now got them all across the line except for around five. It’s also being implemented in type 3 emergency centres.”

Dr Hughes did not name the five trusts which have not yet been transitioned to the new system.

NHSE’s lead emergency care clinical adviser Cliff Mann said he was urging the national commissioner to earmark some capital funding for trusts to build new units or help transform existing facilities so they can deliver same day emergency care.

The Society of Acute Medicine told HSJ last year the NHS long-term plan’s ambition to increase the proportion of patients receiving ambulatory care was welcome but would need more staff to deliver.

SAM president Nick Scriven said that if the NHS could ensure 30 per cent of patients were seen in SDEC units rather than admitted to a bed this would equate to roughly 1.3 million patients a year which would free up beds and help flow across the whole system.