New AEC Unit at Cheltenham Ready to Take Referrals

Our new Ambulatory Emergency Care (AEC) unit at Cheltenham General Hospital is now ready to take GP referrals. This unit joins the AEC at Gloucestershire Royal which has been open since last September.

AEC is a national initiative designed to reduce admissions, take pressure off Emergency Departments and most importantly, to improve the quality of care for our patients. The new service provides same day emergency care to patients which means patients are assessed, diagnosed, treated and are able to go home the same day with or without follow-up care.

Suitable medical patients will be accepted when there is capacity within our AEC units and there is a reasonable prospect of the patient being ready for discharge within the opening times of the unit.

The AEC units at both our Hospitals can now take referrals from GPs  via the Single Point of Clinical Access helpline: 0300 421 0300

Patients can also be referred to the AEC by staff in our Emergency Departments (A&E).

The AEC at Cheltenham General Hospital

This Unit opened on 6th May 2014 and is located in College Road Wing, close to the Emergency Department. It is led by a team of Advanced Nurse Practitioners with access to Acute Care Unit doctors.

The AEC at Gloucestershire Royal Hospital

Following two trial phases held in 2013, the AEC unit went live in September 2013. This is a nurse-led service with access to the Medical Day Unit (MDU) doctor. The unit is based on the ground floor of Gallery Wing (co-located with the Medical Day Unit, previously the Ambulatory Day Unit).

Opening Hours and Referrals

Both our AEC units are open Monday - Friday, 10am - 6pm with the last referral/arrival time accepted at 4pm. This is to allow time for assessment and treatment to be undertaken before the unit closes. The AEC service is in addition to the existing consultant physician call line and the Medical Day Unit services.

The Units accept referrals from GPs via the SPCA and via the Emergency Departments when patients are identified as being suitable for treatment in the AEC. The suitability of a patient for AEC is measured by the use of the AMB Score system. A patient with a score of >=5 can be considered for AEC. 

All GPs in the county will be able to refer patients through the Single Point of Clinical Access (SPCA). 

When you call the SPCA on the GP line (0300 421 0300) they will ask if you would like your patient to be considered for Ambulatory Emergency Care and then guide you through the AMB score. To help this process run as smoothly as possible, the SPCA have requested that GPs have the following information already: 

 

Patient details Surname
Forename

Date of birth
  Sex
  Age
  MRN number
  NHS number
  Any safeguarding issues / is the patient vulnerable?
Accurate NEWS  score Respiratory rate
  Oxygen saturations
  Any supplement oxygen
  Temperature (centrigrade)
  Systolic BP
  Heart rate
  Level of consciousness
Other details Access to public or private transport?
  IV treatment anticipated?
  Acutely confused?
  NEWS score of 0?
  Discharged from hospital within 30 days?

 

Frequently asked questions

What is Ambulatory Emergency Care (AEC)? 

AEC is a national initiative designed to reduce admissions and take pressure off emergency departments.  The new service provides same day emergency care to patients at our hospital, which means patients are assessed, diagnosed, treated and are able to go home the same day, with or without follow-up care.

What type of patient can be referred to AEC?

The service at both AEC Units is nurse-led and can accept patients / conditions which are identified as suitable for AEC by the use of the AMB score (a score of >=5 can be considered), and /or patients who are suspected to have one of the following conditions:

  • Cellulitis
  • Pulmonary Embolism
  • Painless Obstructive Jaundice
  • Anaemia
  • Pleural Effusion
  • Urinary Tract Infections. 
  • DVTs (outside of MDU/ADU opening hours)

 

Will I know what happened to my patient?

Yes, you will receive a report via the InfoFlex Discharge Summary system, similar to those received from the Medical Day Unit (MDU) (previously Ambulatory Day Unit (ADU) at GRH).

What's happening to the existing Deep Vein Thrombosis (DVT) Service?

The DVT service is available at both sites in the Medical Day Unit (MDU at GRH) / Ambulatory Day Unit (ADU at CGH).  At the present time, there is no change to the referral process for GPs.

How do I refer patients to the AEC unit?

Through the Single Point of Clinical Access (SPCA) on 0300 4210300, where you will be asked to provide information to allow them to complete the AMB Score to determine whether the patient is suitable for AEC.  

How to I decide where the patient should go eg ED / AEC?

There are particular exclusions from Ambulatory Emergency Care which are listed on the AMB Score sheet, so if the patient meets any of these criteria they should not be considered for AEC but sent on an alternative pathway (e.g. ED).  All other patients could potentially be suitable for AEC and should undergo the AMB Score system.

How do I transport the patient to AEC ie. do I call an ambulance?

SPCA will arrange transport for the patient if applicable, or if self-presenting the patient should be asked to present directly to the AEC unit.

Does the patient need to go to ED (A&E) first?

No, they should report directly to the AEC unit.

What are the opening hours?

The current opening hours are Monday to Friday, 10am – 6pm.  These opening times will be reviewed to coincide with demand.

What happens if I have a patient who is suitable for AEC but the unit is closed?

For patients referred through the SPCA, the AEC service has established a next-day booking system for patients assessed as being suitable for AEC and are able to wait for treatment.  Outside of the SPCA opening hours, the existing pathways through the Emergency Department and the Medical Day Unit / Ambulatory Day Unit can be utilised.

What are the Single Point of Clinical Access (SPCA) opening times?

Monday - Friday, 8am - 9pm and Saturday - Sunday 9am - 5pm

Who should I contact to discuss AEC?

There are a few points of contact, depending on your query as follows:
For AEC service enquiries, contact the Advanced Nurse Practitioners:

  • GRH0300 422 6676/ 6677
  • CGH: 0300 422 3618

 

  1. For referrals through the SPCA call the GP Line on 0300 421 0300.
  2. For AEC Project Management queries, contact Louise Overton in the GHNHSFT Programme Management Office on 0300 422 4135.