Rapid Response provides a joined up integrated service at home for acute unwell patients, to avoid unnecessary admissions.

Patients will have access to:

• a multi-professional team consisting of nurses, therapists and health support workers, providing support from 8am until 10pm, seven days a week
• an overnight nursing offer from 10pm to 8am, seven days a week
• clinical and social input
• a fast and efficient referral process

Examples of patients who can be seen by the service include those suffering:

• falls
• urinary tract infection (UTI)
• upper or lower respiratory tract infection (URTI / LRTI)
• unstable diabetes
• cellulitis

also those needing:

• urgent new or increasing care packages up to four times a day, in addition to their health or therapy need, limited to care delivered by a single person (single-handed packages of care). 
• Nursing staff within the service have advanced assessment and prescribing skills and will lead on the patients' clinical management.

Assessment and Intervention

All patients referred to the service will need to have been assessed by a GP face-to-face, or by telephone. Patients accepted into the service will be triaged by a senior clinician using your verbal referral. They will then receive clinically appropriate assessments and interventions from relevant clinicians and support staff:

• A face-to-face initial assessment within two hours, four hours or 24 hours, depending on need identified at triage and agreed with you.
• Initial assessments may be by a nurse and/or therapist dependent on clinical needs identified with you at triage.
• Intervention will be for up to seven days or as needed, with patients being directly referred onto appropriate health and care services if required.

Clinical Management and Escalation

The matrons will lead on the clinical input and coordinate the patient's health and care needs until patients are discharged from the Rapid Response service.

GPs will maintain overall clinical responsibility for the patient, matrons can access the virtual ward and responsibility would  transfer to the AEC Consultant. The matron will update you of any concerns and contact you once your patient's intervention has been finalised.

Virtual Ward

Patients for the Virtual Ward (VW) are to be referred via AEC consultant following discussion. The consultant can be reached by calling 020 7272 3070 and asking them to bleep AEC consultant.

All potential referrals must then be discussed by consultant and VW triage via extension 3670.

The team offers a mix of remote monitoring and home visits to patients living in any borough within 40-minute travel from Whittington hospital. VW consists of nurses, occupational therapists, physiotherapists, healthcare assistants, (carers) and therapy assistants. The team also has a GP who provides medical advice to clinicians, provides medical governance to all patients under remote monitoring and also provides home visits to high acuity patients.

VW patients are under the care of the ambulatory care consultant of the day and can be discussed with the team at any point. Out of hours (OOH), patients may be discussed with the on-call medical team and consultant who have overall responsibility for medical patients.

Eligibility Criteria

Inclusions

• adults aged 18+
• resident of  Haringey and Islington
• assessed face-to-face or by telephone by a GP 

The service will travel up to one mile from Haringey and Islington borough borders, for patients registered with NCL (Haringey and Islington) GPs, if this supports continuity of care and is requested by the GP.

How to Refer