Embedded Files
Keeping up with the Jones':
In June 2025, some of our colleagues at the University of Sheffield published an insightful review. They reviewed what evidence there was about how SDEC services have affected the delivery of urgent and emergency healthcare.
(Urgent healthcare and emergency healthcare are different ideas, and you can test your understanding on our SDEC game)
It is important that we in the project team understand this review because we are undertaking our own review and we want to ensure we are contributing something new and useful.
What the researchers found
What the researchers found
The first take-home message from the review was that the published evidence about SDEC services was so poor that the researchers couldn't use the usual methods of combining the evidence. Instead, they opted for a "narrative synthesis", which means they discussed the evidence rather than analysed it in the usual way. It is from this narrative synthesis that we learn about the researchers' other take-home message.
The second take-home message was that it is difficult to characterise SDEC services because they are all so varied and there is a lack of thorough reporting in the published literature. This is useful to know for our project, particularly for informing what to expect from our survey of SDEC services in NHS England.
So, what have we learned from this review?
So, what have we learned from this review?
In summary, the take-home messages were:
1. The published evidence about SDEC services was so poor that the researchers couldn't use the usual methods of combining the evidence.
2. It is difficult to characterise SDEC services because they are all so varied and there is a lack of thorough reporting in the published literature.
Our survey is meant to help us study SDEC services by helping us categorise them. It will be much easier to study types of SDEC services than to study many unique services. It also means we can make general statements about SDEC services that other people can apply to their SDEC service.
If there really are a huge variety of SDEC services, then it might not make sense to talk about them as a coherent thing. For example, it would make sense to talk to your friend about dogs because the category of a dog is well known and we all agree what makes a dog a dog. We know a cat is not a dog and we know a Labrador is just as much of a dog as a husky. But if every SDEC service is different, then the only common characteristic - the only way to identify an SDEC service - is whether or not they call themselves an SDEC service. That makes them very difficult to study.
What we care about is whether the SDEC service is reducing avoidable admissions; it's in the title of our project. Maybe, every hospital has found its own way of doing that. Or, maybe, no one has found a way even though they are trying everything in the name of same day emergency care. Our aim in this project is to find out what is going on, what works best, and how everyone can benefit from this best practice.
We might find it difficult to achieve our aim if the researchers are correct about their first take-home message, i.e. the existing evidence is poor. Fortunately, we are not relying on existing evidence. Instead, we have several years of studies planned to generate the evidence that will answer the questions that we've posed. You can read more about our plans on our 'About the project' page.
What's next?
What's next?
In the end, the researchers say that more research is needed to characterise SDEC services and figure out how they affect the performance of emergency departments. In our project, we're focusing identifying how admissions were avoided rather than simply on whether admissions were avoided. To do this, we will need to characterise SDEC services. That is why we have undertaken our own review of the literature and why we have surveyed almost all the SDEC services in NHS England.
Our next output will be the results of our review and the results of our survey. You can stay informed by signing up to our quarterly bulletin to receive our updates.
Report abuse