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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 patient. With frail patients, this can hinge on frank prognosis identification and considering end of life care planning early on in a care episode.

Community Care Escalation

District nurses are able to perform obervations, dress wounds and take bloods in the community, referred via STRATA form or if urgent via IToCHs

Urgent Crisis Response Team are a 2-hour urgent crisis response service (UCR) available via STRATA form or if urgent via IToCHs 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) 

Virtual Wards can also monitor and treat low/intermediate risk patients in their own home, available via STRATA form or if urgent via IToCHs

Acute Care at Home may be able to offer interventions in the home usually reserved for inpatients for a number of conditions, and can be referred to directly or via via IToCHs

Community Assessment & Treatment Units (CATUs)

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

CATU referral - with the CATU directly, or with the Acute GP service

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

Frailty Advice Line (aka Silverline)

The RCHT Geriatricians are available to support primary care and community-based colleagues with any queries to prevent hospital attendance and support decision making in the community. Call 01872 252161

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 STRATA form

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

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

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