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Oxford Health NHS Foundation Trust

Rapid Access Care Unit (RACU)

The RACU at Townlands Hospital offers ambulatory (non-bed based) care to the local population of patients registered with an Oxfordshire GP Practice.

The service does not accept self-referrals or walk-in patients. Instead, patients can be referred by:

  • General Practices
  • Paramedics
  • District Nurses
  • Hospital at Home teams
  • Single Point of Access teams
  • Out of Hours services
  • Minor Injuries Units
  • Specialist community nurses
  • Acute trusts

We cannot provide transport so it is essential that this is arranged prior to attendance.

Our aim is to offer a one-stop, patient centred holistic service.

Patients will be offered multidisciplinary assessments and treatments on site.

We deliver clinically effective, evidence-based treatments that will reduce demands on secondary care.

We will aim to support individuals in their own environment to avoid admission to the acute services.

Our aim is to provide the highest standard in care and a positive patient experience.

The service is run by doctors, nurses, occupational therapist and physiotherapists. We do not have mental health teams or social workers on site, but we have links to these teams.

Physiotherapists and Occupational Therapists within our multi-disciplinary team in RACU offer high quality therapy input and management plans. They will work with patients and their families/ carers to problem solve and support patients to achieve patient centred therapy and management plans.

Holistic nursing care will be delivered by registered and unregistered health care professionals.

The service is currently:

• Open Monday- Friday only
• Seeing referrals on a next-day basis
• Providing senior doctor cover 9 am to 5 pm, 5 days a week
• The last patient attendance is at 2 pm, to allow for assessment and treatment within doctors hours
• Providing therapy and nursing services until 8 pm
• Blood tests will be processed at the Royal Berkshire NHS Foundation Trust
• Patients over 65 years will be accepted. Those under 65 with co-morbidity and frailty can also be seen, while others may need to be scheduled for attendance on specific days.

The receiving member of staff will assess patients (including observations, blood tests, X-rays, ECG, etc.), followed by an assessment by the appropriate practitioner (medical doctor, nurse, physiotherapist and occupational therapist).

We take a multidisciplinary approach and all patients will have access to the full multidisciplinary team as needed.

We will then make a treatment plan and discuss it with the patient.

Patients will then follow one of these pathways:
• Treatment on the unit with discharge the same day
• Treatment on the unit with a plan to re-attend for further treatment as needed
• Treatment on the unit with discharge home under the Hospital at Home for treatment to continue in the community
• Treatment on the unit followed by admission to one of 4 RACU beds. These beds are only available for a maximum 48 hour admission
• Referral to the acute trust for admission due to clinical severity

Patients can be referred from 8 am- 8 pm for next-day attendance. The latest time that a patient can be seen by the doctors on the unit is 2 pm. Nursing staff are present until 8 pm to continue treatment plans.

On discharge, we will give patients a summary which documents management and treatment plans. We will also send a discharge summary the patients’ GPs.

Who to refer

Patients must be ambulatory and suitable for a next day assessment service.

We are happy to see most ambulatory patients, but given the services available, the following conditions are excluded from RACU assessment and treatment:

• Acute Abdomen
• Acute Asthma
• Acute Coronary Syndrome / Chest pain
• Acute Headache
• Bariatric conditions, where specialist equipment is required
• Fall with long lie (lying on the floor for more than one hour following a fall)
• Focal neurology including Transient Ischaemic Attack (TIA) or Stroke
• Head injury
• Hyperkalaemia
• Post Chemo if at risk of neutropenic sepsis
• Pregnancy
• Raised BM (Hyperglycaemia) in insulin dependent diabetic if DKA suspected
• Sepsis
• Suspected Fracture
• Suspected DVT
• Under 18s

All referrals are to be discussed with the RACU clinician who can offer advice and guidance even if the patient is not suitable for our service.

How to refer

Clinicians can call 01865 903071 to make a referral. (Please note that this number is for use by clinicians only, as the RACU does not accept self-referrals).

All calls will be taken by the most senior clinician (doctor or nurse in charge).

Information will be taken and the referrer may be asked to arrange for tests to be performed prior to the patient arriving in the unit. These would include regular blood tests, cross matching, urine samples
An appointment time will be given for the patient to attend the following day.

We cannot provide transport so it is essential that this is arranged prior to attendance at the RACU.

Older People services

Last updated: 16 August, 2017

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