A new 24 hours a day, seven days a week service providing urgent care within two hours to people across Sutton (both in their own homes and within care homes) experiencing a medical crisis was launched by Sutton Health and Care in October 2022. The aim is to keep people independent preventing an avoidable hospital admission.
Without an urgent response these patients would be likely to be admitted to hospital within two to 24 hours. Examples of the crises patients may experience include:
- Falls without a bone injury or head injury requiring assessment in an emergency department
- An acute infection – such as acute chest infection or urinary tract infection
- A chronic health condition that has got worse – such as a diabetic emergency
- Palliative patients with an advanced care plan where urgent treatment at home is in line with their wishes for end-of life-care
- Social crisis – for example a carer breakdown
- The service is not intended for patients who are very seriously unwell and need emergency care in hospital.
The new 24/7 service, 2UCR, is in line with the requirements of the NHS Long Term Plan for urgent care. It is targeted at adults aged over 18 years in Sutton and runs between 8am and 8pm, seven days a week. The night nursing team provide support to the service between 7pm – 8am.
The 2UCR team is made up of a centralised clinical triage team with and a team of paramedics and nurses with complimentary skills as well as a manager who co-ordinates the team on a day-to-day basis. The triage clinician also has access to physiotherapists, occupational therapists, GPs, rehab assistants and assistant practitioners from the St Helier Home First service.
Home First is a team of nurses, therapists and rehabilitation assistants who facilitate supported discharge of patients from the hospital, prevent admission into hospital from patient’s own homes and work closely with staff in the Emergency Department to also prevent admission into the hospital.
The new 2UCR team replaces existing urgent response services, provided by the care home support team, the Home First team and night nursing teams as well as the service provided by Sutton Primary Care Networks, with one central co-ordinated team. The 2UCR team has standard operating processes and a single point of access for referrals which means that referrals are standardised and makes data capture more efficient.
The 2UCR team treating people at home will be much better for our patients.”Lucy Botting, Director, Sutton Health and Care
Lucy Botting, Director of Sutton Health and Care said: “If we can see a patient at home within a two hour period, we can carry out an immediate assessment and put in a plan of care and services that will support that patient to stay at home. This avoids transfer to hospital via ambulance and, possibly, a lengthy assessment in the emergency department and a hospital admission.”
“Our patients tell us that they would prefer to stay at home if they can. It’s the place they know, where their family can see them and where they feel safe and independent. The 2UCR team treating people at home will be much better for our patients.”
In its first month of operating, the service has received an average of nine referrals a day. Patients who have been triaged and are not suitable for the two hour response are referred via the single point of access to other more appropriate services within Sutton Health and Care. If a patient needs emergency hospital care the 2UCR team will coordinate a safe transfer to hospital for an inpatient admission.
Feedback received from patients has been very positive with one commenting: “Thank you very much to the nurse that came out to see my husband. He was very distressed about having to go to hospital for his catheter issue. The nurse was at our house within an hour of my making the initial call and she was able to sort out my husband’s catheter without him having to be taken to hospital which was wonderful and made us both very happy! Thank you again!”
Referrals to the service can be made by the patient’s themselves, carers, GP’s, 111, the London Ambulance Service or care homes.