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Urgent Community Response (UCR)

The Urgent Community Response (UCR) service (which includes Fast Falls) provides rapid initial assessment and immediate treatment for Newham patients (meeting the inclusion criteria, please see below). This is within their own home (including care homes) and is with a view to preventing a hospital admission when clinically appropriate to do so.  We aim to assess patients within 2 hours of referral.  

Medical care is provided by a multidisciplinary team, which includes Advanced Care Practitioners (ACPs), rapid response nurses, occupational therapists (OTs), physiotherapists and therapy assistants. 

When is it available?

  • The service operates from its base at East Ham Care Centre from 8 a.m. to 10 p.m. seven days a week. 
  • Referrals will be accepted for fast falls between 8 a.m. and 7 p.m. seven days per week and for the rest of the UCR service from 8 a.m. to 8 p.m. 

Who do we accept referrals from? 
We accept referrals from: 

  • The patient’s GP 
  • Community health professionals within East London Foundation Trust 
  • The patient themselves or their relative or carer  
  • London Ambulance Service (LAS) 
  • Physician Response Unit (PRU) 
  • Emergency Departments (EDs) 
  • Social care providers 
  • Nursing and residential homes 

How to make a referral? 
Please call our single point of access (SPA) on 020 8709 5555 between 08:00-19:59hrs, 7 days a week. For GPs, ACPs & ANPs please see the section below for you on selecting option 3 to ‘bypass’ the phone queue to save you time. 

Who we see (inclusion criteria) 
General eligibility criteria that must be met for all patients: 

  • Lives in the London Borough of Newham
  • Registered with a Newham GP surgery
  • Aged 18 years and over, and temporarily/permanently medically housebound 
  • The patient or carer must consent to the service verbally prior to referral 
  • Without intervention from the UCR Service the patient may attend the Emergency Department or be admitted to hospital   

Additional eligibility criteria for the Fast Falls service: 

  • Have had a fall at home or elsewhere 
  • Are at risk of falling 

Examples of referrals accepted by the UCR include (but are not limited to):   

  • Urinary tract infection
  • Upper respiratory infection e.g., tonsillitis, sinusitis
  • Lower respiratory infection e.g., chest infection, exacerbation of COPD
  • Simple eye and ear infections 
  • Cellulitis  (skin infection) 
  • Acute swollen legs 
  • Constipation  
  • Acute deterioration/confusion and at risk of admission to hospital 
  • Reduced oral intake  
  • Skin rash 
  • Mild to moderate pain 
  • Falls  

Who we can’t see (exclusion criteria) 

General exclusion criteria: 

  • Patients without a Newham GP or don’t live within London Borough of Newham 
  • Children 0 – 17 years old  
  • Risks to the patient, carer or health care professional are deemed not to be acceptable  
  • If medical responsibility cannot be identified  
  • Main need is for a social care package  
  • Our team, patient or carer unwilling to participate in treatment plan  
  • Where care can, or should, be met through other services    

Specific clinical exclusion criteria: 

  • Fast evolving systemic illness requiring prompt diagnostic and intensive medical care  
  • If condition deteriorates, needing admission to hospital  
  • Chest pain (unless cardiac (heart-related) cause is absolutely excluded by PRU or LAS)  
  • Head injury with loss of consciousness (blackout) or post-head injury symptoms 
  • Stroke or TIA   
  • Suspected acute sepsis   
  • Severe abdominal (tummy) pain 
  • Acute undiagnosed breathing problems/asthma  or severe breathing problems requiring oxygen  
  • Hyperglycaemia (high blood sugar)   
  • Substance misuse (drugs) with altered Glasgow Coma Score (GCS)   
  • Multiple trauma (e.g. after an attack or crash) 
  • Acute haemoptysis (coughing up blood) or haematemesis (vomiting blood)  
  • Overdose and poisoning (unless patient clinically stable and ingested substance of low toxicity)   
  • Any patients deemed unsuitable at the point of telephone triage ( UCR clinician’s  discretion)  

Specific exclusion criteria for the Falls pick-up service: 

  • Pathological fracture  (broken bone due to a disease like cancer) 
  • Unconscious or reduced level of consciousness (drowsy) after a fall  
  • Bedbound patients who have rolled out of bed cannot picked up with Raizer II equipment.  
  • Patients who need physiotherapy only or occupational therapy only (they should be referred to the Extended Primary Healthcare Team (EPCT)) 
  • Head injury/trauma with associated risk factors such as anti-coagulant medications (such as warfarin, which keep the blood thin) (If unsure please call to discuss further)  
  • Sudden acute medical problems such as abdominal (tummy) pain, chest pain, suspected pulmonary embolism (blood clot in the lung), or severe difficulty in breathing  
  • Severe mental health problem as primary presentation  
  • Alcohol or substance abuse or intoxication as reason for fall   
  • Obvious limb deformity following a fall 
  • Acutely unstable patients requiring hospital admission/readmission  
  • Where it is clear that even with support the patient would be unsafe to leave at home  

Why have we changed from ‘Rapid Response Team’ to ‘Urgent Community Response’? 
This is to align with NHS England’s latest guidance for the provision of Urgent & Emergency Care services.

Address

East Ham Care Centre
Shrewsbury Road
London
E7 8QP
United Kingdom

Opening hours
7 days a week between 8am and 10pm (last referral 19:59)
Telephone number
020 8709 5555 (Ask for Urgent Community Response)

In addition to falls pick-up UCR also will do acute reviews for those who have fallen or at high risk of falling with consequences. Referral is by fully completed referral form returned by secure email to epct.spa@nhs.net

Acute Falls Assessment Referral Form

Referral criteria:

  • 50 years old or older
  • Newham Resident with a Newham GP
  • 2 or more falls in the past 6 months or fear of falling with or without balance and mobility issue which are having a severe impact on activities of daily living including leaving their residence
  • Would not benefit from a simple review by a healthcare professional e.g. physiotherapy only

i.e. needs multi-factoral falls assessment by two or more professions. See NICE Guidance.

  • Is on 4 or more prescribed medications
  • Patient must consent to referral

Exclusions:

  • Falls due to drug/alcohol dependency/misuse
  • Does not consent to review/unaware of referral
  • 49 years old or younger
  • Falls due to an acute episode of illness -> please call UCR for discussion

If you wish to discuss any potential referral please call SPA on 020 8 709 5555 and request to speak with the duty UCR triage therapist.

Referrals for rapid response are accepted following verbal discussion with the team (clinician to clinician). To allow General Practice clinicians to do this more easily we have a dedicated bypass process. Please call our single point of access (SPA) on 020 8709 5555 08:00-19:59hrs 7 days and select option 3 to bypass to the UCR team duty triage.

PLEASE NOTE – This line is for clinicians ONLY – GPs, ANPs, ACPs. Calls via this bypass line by anyone else (e.g. Admin/reception staff, carers etc.) will be directed to call SPA and the call ended in order to keep the line free (as this line is also used for emergency services clinician calls).

In April 2022 Urgent community response was rolled out nationally. Seeing housebound patients over the age of 18 years old but with a primary focus on older adults (50+) and adults with complex health needs. These teams are multidisciplinary and include allied health professionals such as Physiotherapists and occupational therapist. The service should include clinical decision makers such as Advanced Nurse Practitioners who can assess, diagnose and treat a variety of complaints independently.

Urgent Community Response (UCR) in Newham has evolved from the former Rapid Response and Fast Falls teams.

Advanced Nurse Practitioners (ANP)

ANPs are registered nurses who have completed extra training and academic qualification to be able to clinically assess, diagnose, refer and treat patients who present with undiagnosed or undifferentiated problems.

Advanced nurse practitioners are highly trained health professionals that can undertake complex reviews of patients, like GPs. They can assess symptoms and build a picture of a patient’s condition, treat minor health problems, infections, minor injuries and prescribe medication where necessary. They can also often manage more complicated problems, for instance, patients presenting with long-term health conditions, such as diabetes and COPD. Like doctors they often specialise in a particular area such as emergency care, care of the elderly etc.

Advanced Clinical Practitioners (ACPs)

ACPs are healthcare professionals, educated to Master’s degree level or equivalent, with the skills and knowledge to allow them to expand their scope of practice to better meet the needs of the people they care for. ACPs are deployed across all healthcare settings and work at a level of advanced clinical practice that pulls together the four ACP pillars of clinical practice, leadership and management, education and research.

A definition of ACP, its underpinning standards and governance, can be found in the Multi-professional framework for advanced clinical practice in England. The framework ensures there is national consistency in the level of practice across multi-professional roles that is clearly understood by the public, advanced clinical practitioners, their colleagues, education providers and employers.

The roles undertaken by advanced clinical practitioners are determined by the needs of the employer and how they require the level of practice to be deployed within their setting. This may fit with nationally understood roles, such as those within emergency departments or very bespoke roles based upon the needs of a specific population.