Same-day emergency care

Editor – I enjoyed the recent article ‘How do we identify acute medical admissions that are suitable for same-day emergency care’.¹ From a secondary care perspective, it was both clear and comprehensive while acknowledging that there were unanswered questions.

A crucial issue not focused on was how to integrate these patients with primary care. Achieving this poses many challenges, not only because are there workforce issues but also because there has been a divergence away from shared decision making over many years now. One model, published in your journal, offered a partial solution.²

Algorithms and guidelines have allowed a huge amount of progress to be made. Significant challenges remain, however, if good communication, motivation and clinical judgement are not incorporated into the model. Future training of health professionals on both sides of the divide needs to focus on these qualities.