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 if you are looking for alternatives.
This hinges on identifying the very frail and considering end of life care planning early on in this care episode.
In-Home Care Escalation
District nurses are able to perform obervations, dress wounds and take bloods in the community, referred via SERF form
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
If urgent, mark this on the form (page 4, option (1)) as 'admission avoidance' to receive a call back from the CCC team within 15mins.
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).
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 oversight during the day, with band 6 nurses overnight and 111 cover, located at CRCH, Bodmin, WCH.
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
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).