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Aims To explore patients’ experiences of being managed in an ambulatory manner and to explore medical staff’s experiences and attitudes of emergency ambulatory care. Methods Twenty patients and 12 members of staff (nurses, HCAs, junior doctors and consultants) underwent in-depth telephone (patients) and face-to-face (staff) interviews about their experience of emergency ambulatory care. The transcribed interviews underwent thematic analysis. Results Patients’ opinion on ambulatory care is influenced by factors including whether they felt that they were “ill enough” to need to stay in, a fear of staying overnight in hospital and how much they valued their individual home environment. Many thought that this sort of care had been introduced to “save the bed”. Staff were passionate about the service as a good option for many patients who would otherwise have hospital admissions. However, some thought it had been brought in to manage patients who could be managed in primary care. Some factors thought by doctors to influence their decision-making include their perception of the risk involved, previous negative experiences and external pressures such as theatre availability and bed status. There are varied views on whether the service should be more or less protocol-led. Many believe that it is “easier” for them to admit people than manage them in an ambulatory manner. Conclusions There is definitely scope to expand ambulatory care but patients may not engage with this if they feel ill enough to stay in. Decision-making in staff is influenced by a number of factors on an individual level.

british journal of surgery

EP.FRI.949 “When it works, it works brilliantly…. on the days that it doesn’t work, it tends to just all kind of crumble” – a qualitative study of patient and staff experience of ambulatory care on the surgical assessment unit