Service Design & Configuration Committee

Ed Smith, February 14, 2023

We do what it says on the tin. At RCEM the Service Design and Configuration Committee, or SDCC (somewhat less of a mouthful), is all about looking at how the Emergency Department fits into the acute and emergency healthcare system. We house the Same Day Emergency Care Special Interest Group, and the Environmental Special Interest Group has just moved to join us also.

Historically we have been involved with producing guidance regarding crowding and workforce. It is tricky, after all, to design a healthcare system when we are working in crowded departments and without people to deliver the healthcare within it.  The consultant and nursing workforce guidance was authored by the committee. We are about to have another go at crowding, things have moved on!

More recently we have been focussed on what we do and what others do around us, for the benefit of our patients. We produced guidance on initial assessment, for instance, when that all became a bit confusing. More recently we have been grappling with the role of the Urgent Treatment Centre within the urgent and emergency healthcare system: what is it doing, who is it doing it for, is it doing what we think it should be doing and how do we enable our trainees to engage with it? There are many interface issues such as this for us to examine, discuss and produce College guidance on. Other examples include the relationship with primary care (and the potential for GPs to work in the ED), the interface with the ambulance service and Same Day Emergency Care services and how we relate to our inpatient team colleagues.

Along the way we have also been examining the issues facing departments that are “fragile” … typically those that are regarded as either remote, rural or both.

We are frequently approached by others from outside our specialty for advice and support. Often they are looking for assistance in implementation of a specific change in service and we are usually in a position to help. Other agenda items for discussion come from within the specialty – RCEM fellows and members contacting the College with specific queries or pressing issues that they are tackling in their own work environment.

I think that there is much more that we can do with respect to our relationship with the rest of the healthcare system. It often feels to us that there is an assumption that we will always be there, picking up the mess, after our colleagues have vacated their respective premises. For me, SDCC provides us with a vehicle to challenge the status quo and work with colleagues to provide a high quality and sustainable urgent and emergency healthcare system that can really deliver for our patients.

If you are interested in this work look out for the ads to join us: we are about to start recruiting.

Ed Smith

Chair – Service Design & Configuration Committee