MTP8.06 Qualitative thematic analysis of experiences of a Surgical Advanced Care Practitioner led Same Day Emergency Care

Aim A Same Day Emergency Care (SDEC) unit led by Surgical Advanced Care Practitioners (SACP) demonstrates safe and efficient management of the emergency unselected take. However, tensions between the extended team and surgical trainees have been prominent in recent media. This study examines feedback from Surgical Registrars (StR), Foundation Year/Core Trainees (FY/CTs) and SACPs on their experiences with the SDEC model. Methods Thematic analysis was conducted on qualitative responses from StRs, FY/CTs and SACPs focusing on patient care, teamwork, communication and workload. Responses were categorised into positive, negative and improvement-based themes. Data was analysed using the ‘tidytext’ package in R to identify common words/phrases uncovering themes. Results Trainees (StRs and FY/CTs) highlighted the positive impact of SDEC on patient care, efficiency and teamwork, with faster discharge processes and reduced waiting times for investigations. However, challenges emerged, particularly around uneven workload distributions, staff shortages and the physical separation of SDEC from SAU which hindered communication. SACPs acknowledged the benefits of autonomy in decision-making and the supporting team dynamic, but expressed frustrations with high patient volumes and inconsistent senior support. SACPs showed hope for future development with improving coordination with SAU and addressing resource limitations. Conclusion SDEC was thought to positively impact patient care, efficiency and teamwork. However, challenges related to uneven workload management, senior support and coordination remain. Key improvements include better coordination with SAU, increasing staffing during busy periods and stronger senior support. Addressing these issues will optimise effectiveness and improve patient care.