What we do
Urgent Community Response: 2 hour response
The Urgent Community Response (UCR) is a service that has been set up to help adults, predominately older adults, who are having a health crisis or having difficulties being at home because their main unpaid carer is not able to cope with caring for them.
The UCR has been designed to assess and treat patients in their own home (or residential care home) and where it is safe to do so keep them at home.
What is a crisis?
A crisis could include one or more of the following:
- Falls, where there are no obvious injuries, and the patient hasn’t fainted
- Frailty: a condition leading to a loss of strength and ability to do day-to-day things
- Sudden or a gradual decline in mobility
- End-of life-support: how to manage symptoms and pain relief in line with the person’s wishes
- Equipment assessment that may lead to equipment being provided so the patient remains safe
- Suddenly being confused or increasing confusion
- Catheter management such as blockages or other pain associated with it
- Diabetes support, where there are concerns over a person’s blood sugar levels
- Unpaid carer breakdown, where the usual carer is not able to due to their own ill health or carer stress.
Who is the service for?
The service is open to all adults over the age of 18 although most patients tend to be aged 70+ with complex needs.
How can I be referred?
Patients are referred to the service via a number of routes including:
- The ambulance service (if you have phoned 999 and a paramedic has attended),
- Your own GP
- Other NHS Community Services (who may already be visiting you for more planned care)
- Social Care and the Local Authority
If a patient is already being visited by a community service for planned care, the patient will have a contact number for the visiting team. If the patient rings this number and the call is assessed as urgent, the patient may be put through to the urgent community response team.
How quickly will I be seen?
The UCR service aims to see people within 2-hours. A UCR clinician will visit to carry out an assessment and develop a treatment plan which will be agreed with the patient and / or their family.
The UCR clinician may start treatment and if appropriate and then refer you on to another team or to your GP, who will continue with the treatment and monitoring until they are better.
The UCR team can also make referrals to other parts of the NHS for example physiotherapy and occupational therapy, as required.
Why is it better to be treated at home?
The UCR’s aim is to treat people in their own home, or residential care home, because it is always better for an older person’s long-term independence if they can stay in their usual place of residence instead of being admitted to hospital.
This is because being inactive leads to deconditioning and muscle loss which can then limit their ability to live independently once they have been discharged.
Information for healthcare professionals
Since the UCR service was established, it has been working with the ambulance service to develop a ‘fallers pathway’ due to the high numbers of calls to 999 regarding patients who have fallen.
The objective of the pathway is to avoid a patient being conveyed to hospital and for them to be managed at home, where it is safe to do so.
Now when a member of the ambulance service arrives the paramedic can ring the UCR and they can discuss the patient and decide whether they can be treated through the UCR service instead of being taken to hospital.
Oxford Health is trialling the use of smart monitors known as ‘wearables’ with some of its Hospital@Home patients so that clinicians can check vital signs remotely, enabling them to act if a condition deteriorates.
If a patient is taking part in the study there will be a note of this on CareNotes.
The study will run until March 2023. Read the story on the news pages here.
Green Wrist bands initiative
The UCR, Hospital @ Home and EMU / RACUs are currently piloting a three-month study where patients seen will be given a green wrist band to wear. The idea is to alert the ambulance service or other visiting clinicians that this patient already has been seen by the UCR and will likely have a treatment plan in place. An alert will also be added to Carenotes to notify others of the patient’s status.
The team expect to have some initial results in November 2022.
We work with the following partners:
We work with Age UK to refer people to their Community Information Network team.
They facilitate conversations with patients and relatives to promote self-care, and personalised solutions that enable them to remain independent at home, in control of their care and living life to the full.
The Networkers focus on a very wide range of needs including those that are:
- Social, such as reducing isolation
- Physical, including helping people with their levels of activity and being able to manage at home
- Emotional, improving resilience and mental health and
- Practical, such as giving general advice as well as highlighting access to entitlements.
Age UK provides this support via the telephone, home and garden visits, email/text or talks to groups. It also offers a wide range of fact sheets and guides and hosts information events and stands.
The community networkers will take referrals from all our services. To refer, just let them know the patient’s name and contact details.
The South Central Ambulance Service (SCAS)
The UCR has worked closely with SCAS to develop a process where patients can be evaluated to assess whether, with the appropriate care, they can remain in their home instead of being taken to hospital.
Now when the paramedic visits a patient’s home they can call the UCR team and agree on a treatment plan for the patient. If required, a conference call with a medic can provide further support to agree the best care for the patient.
Oxford University Hospitals NHS FT Emergency Departments
Oxford University Hospitals Same Day Assessment Unit
Oxfordshire County Council
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Page last reviewed: 19 August, 2022