Urgent Community Response and Barnet Hospital at Home, previously Rapid Response & Unplanned Care, aims to prevent avoidable admissions and avoid readmissions by providing support in the community via the Barnet urgent community response and hospital at home (step-up) access.

The care process is as follows:

• contact will be made with the patient or their representative by phone, and arrangements made to visit within two hours
• initial assessment will be carried out by a qualified nurse
• patients will receive at least one visit per day
• patients will be supported within the team for up to 72 hours (on occasion, 120 hours if required)

The teams manage a range of conditions, including acute exacerbations and acute complications of long-term conditions, in the community. They also support frail and elderly people who have experienced a fall but do not require hospital care, and those with pneumonia or a urinary tract infection.

The service is available at short notice, into the evenings and at weekends, and it also supports rapid transfer home from urgent care centres/A&E in order to avoid hospital admission. Care is handed over to mainstream services within a few days (typically on day three, maximum day five).

The rapid response team provides patients with urgent community health care within two hours to avoid a health crisis and possible hospital admission.

Hospital at Home (step-up)

There are two step-up services available to Barnet residents, delivered by CLCH and RFL:

• Barnet Hospital at Home, for patients with enhanced nursing or therapy needs who are suitable for treatment at home with face-to-face visits from nurses or therapists,
• Barnet Remote Monitoring, for patients at Barnet Hospital who don't require face to face visits and can be monitored remotely using technology provided to the patient.

The Barnet Hospital at Home service is available via Barnet Urgent Community Response (UCR), which will refer clinically suitable patients for acute consultant-led management of their acute episode at home as required. 

The Barnet Hospital at Home services are also available via referrals to the Barnet Hospital Adult Assessment Unit Hub (AAU).

Hospital at Home services support patients of a higher acuity or clinical complexity than those supported by Urgent Community Response as the patient is under the clinical oversight of an acute consultant, rather than their own GP. 

Medicines Management

Note that all medicines governance and oversight sit with the Hospital at Home team while the patient is under their care. This is to reduce the risk of duplication or other incidents. If you have any questions or concerns about an individual patient please contact the service directly. Medicines supply arrangements may vary across VWs.

For further details on Hospital at Home in north central London, visit the NCL ISC website.

Eligibility Criteria

Inclusions

Urgent community response (UCR)

• residents of Barnet aged 18+ who are experiencing a new onset/ deterioration in a person's health that requires treatment within 2 hours
• frail patients or have a CMC flag
• assessed as safe to be at home with this service by a GP
• conditions managed include, bowel management, catheters (blocked), cellulitis, chest infection, dehydration and diarrhoea, equipment provision, falls, frailty & associated conditions, UTI/ confusion and wounds (simple)

Hospital at Home and Barnet Remote Monitoring services

• residents of Barnet aged 18+
• require acute hospital level care for up to 14 days
• can safely receive care at home
• conditions managed include, acute kidney injury, atrial Fibrillation (unless patient on AF Virtual Ward pathway) delirium, dementia (suspected or known where risk is deemed manageable in the community), COPD (requiring oral or once daily IM/ IV Abx and daily monitoring), falls, pneumonia, trial without catheter, UTI or Pyelonephritis, other conditions by discussion

Exclusions

• homeless patients.

How to Refer