Key Messages

UCR is designed to:

• Prevent unnecessary admissions to hospital or long-term/residential care
• Provide a robust multi-agency 2-hour crisis response
• Reduce the duration of hospital admissions for patients requiring intermediate care
• Support people in crisis to remain in their usual place of residence and improve people’s outcomes

Crisis is defined as:

An acute change in an individual’s circumstances leading to an increased need in health, or health and social care need which if not supported would lead to admission to a more acute setting within 24-48 hours.

Referral criteria

• 18 or over years of age

AND

• registered with a Plymouth GP or be out of area but attending UHP’s Acute Assessment Unit

AND

• have health or eligible social care needs (meeting intermediate care criteria) that would require hospital admission within 48 hours without the support of the UCR

Typically support provided by the UCR should not last more than six weeks. Most episodes will be much shorter than this, for example 1-2 weeks following acute treatment for pneumonia, or 2-3 weeks following treatment for hip fracture.

The UCR team has a variety of healthcare professionals within, including:

• Registered general nurses
• Registered mental health nurses
• Community care workers
• Social workers
• Occupational therapists
• Physiotherapists
• Paramedics
• Acute Response Practitioners (ARP’s) - trained to examine, diagnose and formulate treatments plans. Generally, these visits will be requested by a GP/SWAST

Out of scope:

• The UCR service is not appropriate for patients requiring a long-term increase to existing support or long-term care provision and are not in crisis.
• Patients requiring package of care +/- placements for end-of-life care should be referred via St Luke’s Hospice, not the UCR.

To respond to acute increase demands within UHP, the UCR team will visit the Emergency Department, acute assessment unit and short stay wards as part of the admission avoidance initiative.