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Alternatives to acute admission to RCH

Acute medical admission may not always be in the best interests of the care of our community. Discuss with the Acute GP service or submit a SERF if you are looking for alternatives. If you are looking to check on the progress of an already submitted SERF, please call the IToCHs directly.

This hinges on frank prognosis identification and considering end of life care planning early on in this care episode.

Community Care Escalation

District nurses are able to perform obervations, dress wounds and take bloods in the community, referred via SERF form 

Urgent Crisis Response Team are a 2-hour urgent crisis response service (UCR) pilot available via SERF form (there is a pilot where some PCNs have a direct dial number) for any patients that meet the criteria 

Care Home Support Team can independently review and advise on those patients in Care Homes (residential and nursing) 

Please also see the Virtual Wards to monitor intermediate risk patients in their own home

Acute Care at Home may be able to offer interventions in the home usually reserved for inpatients for a number of conditions

All the above services can be referred to via the Single eReferral Form (SERF) form 

If urgent, mark this on the form (page 4, option (1)) as 'admission avoidance' to receive a call back from the IToCH team within 15mins.

End-of-Life Community Care

These are managed by the palliative care specialist nurses, please click the link above for more detail

Adult Mental Health referrals are handled through the acute psychiatry services

Social Care Escalation

For patients with progressive or predictable care needs that have no acute medical concern to require admission (eg dementia patients requiring a package of care). 

Referral is via the Single eReferral Form (SERF) form

Please see the here for more information on how to use the SERF.

Acute Respiratory Infections clinics have been set up to cope with recurrent high demand waves around RSV, Strep A and ongoing Covid concern. Click the link for further details.

Urgent Treatment Centres are offered in Camborne-Redruth and West Cornwall Hospital for acute primary care with diagnostics

Minor Injury Units are offered in Camborne-Redruth, Bodmin, Falmouth, Newquay, Liskeard, St Austell, Helston and West Cornwall hospital for minor injuries

Bedded Care Escalation

Community Assessment & Treatment Units (CATUs)

For patients with an acute medical need that cannot be cared for with the above services in their own home, where an acute admission to RCH (poor prognosis or ceiling of care ie Rockwood 5 or more, multiple comorbidities, clear advance directive documented, etc) is inappropriate. 

CATU patients should be likely to benefit from some POC diagnostics +/- witnessed response to initial treatment (eg iv fluid), and to go home or to bedded care after CATU care.

CATUs are staffed by a ward doctor with GP oversigh
t during the day, with band 6 nurses overnight and 111 cover, located at CRCH, Bodmin, 

CATU referral

Please discuss CATU referrals with the Acute GP service

[AGPs click here for contact details]

Please ensure an accompanying TEP & patient profile (+/- expected death form where appropriate)

WCH may still take admission directly - via bed manager on-call

Frailty Same Day Emergency Care (FSDEC) Unit

This is based at RCH for frail patients that need short stay work up (<12hrs) or treatment and can then return home

Social Care Escalation

For patients with progressive or predictable care need that has breached the threshold of what can be provided in the community (eg dementia patients requiring more than a qds package of care). 

Referral is via the Single eReferral Form (SERF) form, open for referrals from GPs, 111 and SWAST.

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