The Royal College of Physician's vision for future hospitals proposes that patients be reviewed by a senior clinician as soon as possible after arriving at hospital.1,2 It encourages specialist medical teams to work together with emergency teams, to diagnose patients swiftly and to facilitate early discharge.3 In our hospital, ambulatory emergency care (AEC) was established in October 2015. All non-ambulatory medical patients referred by general practitioner (GP) were directed to the emergency department (ED). The ED referred patients, who would also wait long hours for medical beds. All non-ambulatory, same-day care was managed in the ED, acute medical unit (AMU) or frailty emergency …