Urgent Community response service: Keeping people out of hospital

The Urgent Community Response service, based at South Warwickshire Foundation NHS Trust, provides urgent support seven days a week to help prevent hospital admissions. This service is for adults with certain conditions and particularly the elderly and frail. 

The service offers a two-hour crisis response, a same day response and virtual wards to help reduce hospital admissions. A full assessment is carried out and treatment provided based on the patient’s needs, which would normally only be available in hospital. Where possible people are kept at home, avoiding the need to convey them to hospital in an ambulance or for families to take them in. This is always in discussion with the patients and their family and evidence has shown remaining at home in familiar surroundings can also produce better health outcomes. 

Mr Har Singh was one patient who has been referred to this service and his family have seen the benefits to this more personalised approach to care. 

Mr Singh is now 84 and was fit, well and active until 2019 when he suffered a stroke which left him paralysed down his right side and unable to walk, talk or care for himself. 

His daughter, Bally Toor, explains: “Although he was on medication following a heart attack, he was fit and active, worked on his allotments, got out and about, had a busy social life and was active around the house, helping with the cooking and cleaning. 

“He was admitted for a hernia operation and was taken off Apixaban – a drug used to prevent blood clots and reduce the risk of heart attacks and strokes. Unfortunately after returning home he suffered a massive stroke. Mum was out the house with a member who was undergoing a heart procedure and so he was on the floor for six hours before he was found.” 

Mr Singh was discharged from hospital after a couple of months and the family arranged care to support him to live at home. Although he started to recover, his health took a dip in December 2021 and he was put on end-of-life care. He recovered but when his family or carers spot any signs of infection, he needs immediate care. 

It was when he contracted a serious chest infection that the Urgent Community Response team were alerted. The family called an ambulance, as they had previously, but instead of assessing him and taking him to hospital, the ambulance service called in the Urgent Community Response team. This led to a totally different experience for Mr Singh and his family. The response was rapid and the family felt more aware and engaged with his care. This care was all managed and carried out within the team and not multiple services.  

Bally said: “There was continuity of care and the benefit of dealing with a small team that all knew what was going on. It was the first time he had received this level of care and response to an infection. Had it been available earlier, we may have avoided some of the situations we found ourselves in and dad’s health may not have declined as much as it had.”

The Urgent Community Response team were able to keep Mr Singh at home rather than admit him into hospital – which nobody wanted to happen. They immediately provided antibiotics to tackle the infection and then waited. Although at one stage he was so unwell they considered hospital admission to administer IV antibiotic. Concurrent prescriptions of oral antibiotics did the job and he was able to stay at home. 

From Bally’s point of view, the UCR team provided reassurance and were a breath of fresh air; “We had total respect for the nurse as communication was clear and we understood what the next steps were at each stage.–There was a feeling of control of the situation.” 

The team were at the home for around three days and Bally adds: “My dad was treated as a human and an individual rather than just another patient. Communication was open and available and we all felt there was someone at the end of the line that knew what was going on. It was a contained package of care that got him through a blip.” 

Mr Singh was discharged to the care of his GP and avoided hospital admission – which was hugely important to him and his family.