Agenda item

 

This item is to receive an update from The Rotherham NHS Foundation Trust (TRFT) in relation to the success and impact of the SDEC since its implementation, following funding being secured to develop the facility.

 

 

This item was to receive an update in relation to the success and impact of the Same Day Emergency Care (SDEC) Centre since implementation.  This followed the initial proposal regarding the SDEC being presented to the Health Select Commission in March 2025.

 

The Chair welcomed Bob Kirton, Managing Director of TRFT (The Rotherham NHS Foundation Trust) and Jodie Roberts, Director of Operations at TRFT to the meeting and invited them to introduce the presentation.

 

The Director of Operations delivered a presentation regarding TRFT’s development and implementation of the new Same Day Emergency Care (SDEC) Centre, and set out the pressures that had driven the change, the capital funding that had enabled it, and the early impact on flow, performance and both patient and staff experience.

 

They explained that Emergency Department (referred to as UECC, the Urgent and Emergency Care Centre) demand had been rising year on year and that attendances had increased by 12% from the previous year into the current financial year, which had contributed to crowding, limited assessment space, longer waits and a poorer experience for patients and staff.

 

In response, the Trust had pursued a time-limited NHS England capital opportunity, had prepared a business case at short notice, and secured £7 million in funding.  They emphasised that this funding had supported a broader programme of enabling works and service moves, not just the SDEC in isolation.

 

The Director of Operations outlined the delivery timeline, from bid to opening and the considerations taken at each stage. The Trust had then designed new ‘front door’ services with the intent that patients could be seen in the right place, at the right time, by the right clinicians. The new build had increased the Emergency Department footprint, eased overcrowding, created more clinical spaces and improved waiting times, whilst also enabling the creation of an urgent Primary Care area and relocating the Minor Injuries Unit into the new SDEC footprint to free additional space in the UECC.

 

She described the wider reconfiguration required to unlock the space:

 

·       The Fracture Clinic had moved from the front of the hospital, with the new location expected to open toward the end of 2026

·       Sexual Health had moved out to create the necessary Fracture Clinic space, with its revised front-of-hospital location due to open within the next few months

·       Pre-operative assessment had moved to allow Sexual Health to relocate, with pre-op assessment now based at the back of the hospital

 

The Director of Operations noted that several services had therefore benefited from improved accommodation, but that delivering this had required significant organisational operational and logistical effort, which had included moving around 600 staff whilst retaining focus on the wider benefits despite understandable sensitivities around change and disruption.

 

They described that a former corridor and room layout had been knocked through and rebuilt into the dedicated SDEC environment with individual cubicles, seating areas, two waiting rooms and multiple clinical spaces, including rooms supporting minor injuries as patients entered the service.

 

Turning to access and pathways, the Director of Operations described a key enhancement introduced after opening: a direct access pathway that had not been available when the unit opened in July, enabling Yorkshire Ambulance Service (YAS) crews to bring suitable patients straight into SDEC and avoid attendance at the UECC. From August 2025, local GPs had also been able to refer directly into SDEC, and they reported positive feedback from Primary Care and other professionals.

 

They described that the model had also supported planned next-day returns for follow-up treatment and had enabled community ‘in-reach’ meaning that  so where safe and appropriate, patients could be treated and returned home and unnecessary admissions avoided. The Director of Operations explained how the team had made SDEC clearer for patients through a plain-language infographic which explained that whilst many people expected care to fit the four-hour emergency standard, SDEC was designed for patients likely to need longer assessment and treatment without requiring admission, typically up to around eight hours.  The infographic was supported by QR codes and paper leaflets that set out the core elements of the pathway.

 

They shared early activity and performance observations, noting that SDEC attendances had increased markedly in 2025, and contrasting this with 2024 when the previous medical SDEC area had sometimes been used for inpatient bedding over winter and emphasised that the new facility had been designed specifically to prevent beds being placed there, protecting same-day capacity and reinforcing the principle that people were generally better at home when admission was not necessary.

 

The Director of Operations linked the programme to wider improvements in four-hour performance, whist acknowledging multiple contributory initiatives, but highlighting that the extra clinical space had helped patients be assessed and reviewed by medical teams in a more timely manner.

 

They closed with examples of positive patient feedback gathered through a variety of feedback routes including the Friends and Family Test and direct emails, and noted how encouraging it had been when patients referred to staff by name and recognised the multidisciplinary team’s contribution.

 

The Chair thanked the Director of Operations for the presentation and invited questions and comments from Members in relation to the update provided.

 

Councillor Thorp offered thanks for both presentation and preceding visit to the facility. They explained that prior to attending, they had imagined the facility might feel like a collection of isolated areas where patients waited without understanding their place in the process. However, after first-hand experience, they had observed a system that worked smoothly and created a positive, calm  patient experience. Councillor Thorp queried the rising attendance figures from 2024 to 2025.  They wanted to understand whether the figures were linked to what used to be Ward B6 and whether the sharp increase had caused any difficulties.

 

The Director of Operations explained that although attendance had risen significantly, this was what the team had anticipated and wanted. They explained that Ward B6 had not been an environment suitable for expansion, as its configuration previously included beds which restricted patient flow. In the new SDEC Centre, the space had been purposely designed to cope with growing demand. It was acknowledged that attendance had recently reached more than 70 patients in a single day, alongside high UECC volumes, but confirmed that the workforce structure remained adequate, whilst adding that the team continued to monitor capacity closely.

 

Councillor Thorp asked what had become of Ward B6 following the opening of the SDEC.

 

The Director of Operations explained that Ward B6 had been repurposed as a ‘decamp’ ward to support temporary moves during ward refurbishments, including the current Haematology Ward project. They noted that B6 had originally been built during COVID as a high?specification critical?care overspill area, making it valuable for inpatient or day?service use as and when required.

 

Councillor Rajmund Brent wanted to know if the Trust understood why there had been a 12% year?on?year increase in attendance.

 

The Director of Operations advised that this was difficult to pinpoint but reflected rising patient acuity, increased walk?in presentations, and a notable upturn in working?age adults using the UECC. The system was exploring ways to ensure patients accessed the most appropriate services rather than defaulting to emergency care.

 

Councillor Brent observed that as awareness of the new facility grew, demand would likely continue to increase, creating the risk of future overcrowding. He expressed concern that the calm, comfortable environment could be compromised if that trend continued unabated.

 

The Director of Operations assured Members that the unit had been built with future adaptability and growth in mind. The clinic?room capacity exceeded current demand, and the layout could be reconfigured quickly to respond as care models evolved. They added that long?term sustainability would depend on strong collaborative work with Primary Care and Yorkshire Ambulance Service to ensure patients were directed to the best setting from the outset.

 

 TRFT’s Managing Director offered a broader perspective, praising the clinical and operational teams for managing what had been an extremely challenging winter. They described how SDEC provided an essential pathway for patients whose needs had been assessed by clinicians and who required same?day intervention without the delays associated with traditional Emergency Department delays. They further explained that Rotherham had become one of the few areas in Yorkshire and the Humber able to ‘pull’ patients directly from ambulance workloads into SDEC, easing system pressure and emphasised that although the model had strong potential, significant cultural change across the public and partner organisations would be required to address uncontrolled growth in emergency care attendances.

 

Councillor Harper then reflected on experiences of Ward B6,  and commented that the new facility was incomparable in terms of quality of the environment. They wanted to understand whether the SDEC was an enhanced version of Ward B6 or a fundamentally different service, and whether it had directly improved waiting times in A&E.

 

The Director of Operations clarified that the new facility was not an extension of B6 but a purpose?built facility informed by national best practice. They confirmed that it had contributed to improved performance in areas such as ambulance handover times, time?to?clinician, and four?hour targets, though she emphasised that multiple initiatives across the Trust had also contributed to those improvements.

 

Councillor Harrison asked how success would be measured for the new facility and how success measures had been developed.

 

The Director of Operations explained that the evaluation model aligned with national Emergency Care Access Standards, assessing how efficiently patients were seen, treated, discharged, or admitted. Low readmission rates suggested safe decision?making, while staff satisfaction, boosted by the predictable midnight closing time and improved working environment, was also a key indicator. A comprehensive analysis would take place after a full year of operation.

 

Councillor Ahmed echoed the positive impressions but raised concerns about public awareness regarding the facility, and reflected that many residents still defaulted to A&E even for minor concerns. They also noted that residential and care homes frequently called 999 to transfer responsibility to the hospital when other means of accessing care were more appropriate. They asked how cultural change could be encouraged and enquired whether a sensory room could be incorporated into the SDEC footprint for patients with learning disabilities.

 

The Director of Operations confirmed that a sensory room existed within the SDEC but had not yet been fully equipped due to budget constraints. The hospital charity had undertaken fundraising to allow its completion. They agreed that culture change would require strong system?wide communication and collaboration. TRFT’s Managing Director reinforced this, noting that differences even between care homes in their 999 call rates demonstrated the scale of the cultural challenge. They highlighted that many frequent attenders at UECC had social, housing, or wellbeing needs rather than medical ones, stressing the importance of multi?agency work to address systemic stressors.

 

Councillor Ahmed suggested more community?based engagement, including with groups such as REMA (Rotherham Ethnic Minority Alliance) and VAR (Voluntary Action Rotherham, and encouraged the Trust to adopt a firmer stance when redirecting people to more appropriate services.

 

Councillor Adair shared their personal positive experience of SDEC praising the speed and reassurances taken from the service received.

 

Councillor Brent reiterated others’ views regarding the quality of the environment and noted the  visible LGBTQ+ positive signage, lanyards, and badges. They asked whether similar visibility could be introduced for neurodiversity and learning disabilities, and whether this was indicative of local leadership within the SDEC or part of a wider Trust policy around overt inclusivity.

 

The Director of Operations confirmed that no equivalent materials for neurodiversity or learning disabilities currently existed but committed to take the would take the suggestion forward. They explained that the organisation aimed to be open and welcoming for all, and that inclusivity was embedded in the Trust’s philosophy. The Managing Director added that although some areas were delivering excellent inclusive practice, consistency across all patient?facing areas remained a development goal.

 

Resolved:

 

That the Health Select Commission:

 

1.    Noted the update in relation to the SDEC and its impact on patient care.

 

2.    Requested that TRFT provided further data regarding the impact on waiting times, ambulance handover, staff and patient satisfaction following 12 months of operation or following a suitable period of adoption of direct referral routes to all partners for whom this was intended to assist members to fully understand the impact of the SDEC for Rotherham residents.  The means via which the data would be provided, along with any specific considerations around metrics and a finite timeline would be agreed with TRFT in due course.