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Urgent Community Response (UCR) Service (from 6 June 2022)

  

The UCR Service - an NHS alternative to sending an ambulance, helping people to stay at home, using clinical practitioners including paramedics, therapists and nurses to deliver an urgent two hour crisis response and/or reablement response within two days to avoid hospital admission.The UCR service differs from the Paramedic Acute Visiting (PAVs) in offering wrap-around care and monitoring (and may require GP liaison for prescribing)


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Coventry Guidance  

About the Urgent Community Response (UCR) Service – GP Referral Guidance

 

Two Hour Admission Avoidance – Crisis Response:

Reduces preventable hospital admissions through a multi-skilled team to support people in their usual place of residence presenting with an urgent care need (within two hours).

Includes a holistic clinical assessment and commencement of short-term intervention(s) required (typically lasting up to 72 hours).

NB Not all patients will meet these criteria – there are also 4-6 hour and 24-hour dispositions – your patient will be prioritised based on clinical need

Two Day Admission Avoidance – Reablement Response:

Provided by a multi-skilled team to maximise independence via an assessment and intervention(s) to achieve goals set with the person, regaining their skills, confidence, and independence, and enabling them to do things for themselves (typically a time-limited service).

Patient Referral Criteria

  • Acute infection/acute exacerbation of a long-term condition
  • Fall (with no obvious bony injury, but unknown cause of fall)
  • Reduction in mobility/functional ability and/or urgent equipment needs
  • Blocked/expelled catheters (urethral/supra-pubic) for both males and females
  • Main carer/family member unwell or gone into hospital and patient requires a nursing intervention (e.g., moving and handling/medication prompting/toileting/dietary needs), to avoid hospital admission
  • Acute social crisis whereby the patient is at risk of hospital admission.

Please consider if your referral would be appropriate for PAVS before making a referral to UCR

Patient Inclusion Criteria

  • Over 18 years old and presenting with acute physical or functional deterioration
  • Unable to access ambulatory services due to frailty, mobility issues, acute illness, and/or chronic long-term condition
  • Registered with a Coventry GP
  • Living in their usual place of residence, including Care or Nursing Home.

Patient Exclusion Criteria

  • Acute medical emergencies e.g., suspicion of CVA/MI/acute abdomen/SEPSIS (signpost to A&E/999)
  • Suspicion of malignancies (signpost to appropriate 2-week wait specialty)
  • Fall with suspected bony injury/long lie over 6 hours (signpost to A&E/999)
  • Palliative/end of life patients without acute medical need (refer to Place Based Team/specialist palliative care team)
  • Head injury – with loss of consciousness and/or patient on anti-coagulation medication
  • Pregnancy – issues with pregnancy/or acute health needs and pregnancy
  • Seizures
  • Mental health needs including acute crisis (signpost to Coventry Crisis Team)
  • No fixed abode/alcohol withdrawal/intravenous drug abuse (access Walk in Centre/A&E/999)
  • Not registered with a Coventry GP (access Walk in Centre/999/NHS111)
  • Chronic long-term conditions, no acute health need, requiring care support (signpost to Social Services).

Hours of Service

Weekdays: 8:00am – 8:00pm (Referrals close at 6:00pm)

Weekends: 8:00am – 4:00pm (Referrals close at 2:00pm)

How Do I Refer?

TWO STEPS:

  • FIRST EMAIL REFERRAL
  • THEN GP FOLLOW UP PHONE CALL  (pending EMIS Integrated Care Record, Autumn 2022)

Process:

  • GP checks admission avoidance referral criteria met (see above). Submits Referral Form to ISPA@covwarkpt.nhs.uk with subject heading: UCR GP Referral.  Central Booking Service will attach referral to documentation for Triage Clinician pending triage (as per current process for West Midlands Ambulance Service University NHS Foundation Trust referrals)
  • GP Practice telephones 0300 200 0011 and selects Option 3 for UCR (Option 2 is for OOH) to discuss.

Discharge Summaries

Within 24 hrs of discharge, UCR send a discharge summary via secure email to the GP practice nhs.net account from CWPT_UCR@covwarkpt.nhs.uk, with the subject heading: “UCR Discharge Summary – Please Scan into GP Patient Notes Immediately”

 

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