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“Extended emergency medicine” areas will be opened in hospitals for A&E patients whose care can’t be turned around within the four-hour target, according to new national guidance.

NHS England has released new guidance on a “model emergency department” to provide a blueprint for A&Es to meet national targets.

The guidance – delayed since last year amid internal concerns about its usefulness – recommends the use of new “extended emergency medicine ambulatory care areas” (EEMACs).

They are intended for patients who are expected to be sent home following investigation and treatment, rather than admitted, but would likely be in A&E for more than four hours.

It is a similar approach to the “same day emergency care” units now running in many hospitals. However, SDECs are primarily run by specialists, rather than A&E staff, whereas EEMACs are for patients needing more general emergency attention.

If a patient is moved to an EEMAC within four hours, they will count as having met the headline waiting target, NHSE confirmed to HSJ. However, if they reach 12 hours, they will be counted as a breach against the 12 hours in the department measure. The same approach applies to SDEC.

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Source: HSJ, 9 February 2026

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