Strata IToCH SOP: Managing 2-Hour Urgent Crisis Response (UCR) V0.14

Procedure overview

Guidance for Transfer of Care Hub (ToCH) staff on how to record referrals for 2 hour urgent community response (UCR) in the Strata Pathways referral management and/or RiO systems. UCR referrals are for people in their own home a risk of acute hospital admission.

GPs and ambulance crews will be the main referrers and may make referrals via the phone (recommended), a Strata Pathways referral or web referral

Principles

• Criteria for a 2 hour Urgent Community Response is included in Appendix 2
• UCR referrals should take highest priority and be triaged and actioned before all other referrals.
• Referrers are encouraged to refer by phone.
• ToCH staff responsible for monitoring and reviewing web-referrals should routinely scan new referrals for UCRs so processing can be prioritised.
• Referrers should be contacted within 15 minutes by a ToCH prioritiser to determine need. The ToC is responsible for quickly sourcing the required capacity through liaison with the relevant community services by phone and notifying referrer of the outcome. Strata should not be used to make onward referrals to receiver services.
• RiO, not Strata, remains the primary data source for local and national UCR reporting. Strata will only ever hold a sub-set of all UCR referrals and for this reason should not be used for accurate reporting.

Other (reference documentation)

• CFT SOP – Recording UCR’s in RiO
• Transfer of Care Hub Handling urgent telephone calls SOP
• Transfer of Care Hub how to change Strata referral priority guidance

Procedure

There are 2 scenarios to be considered:

(i) UCR referrals where the ToCH prioritiser determines a 2 hour UCR triage outcome is appropriate
(ii) UCR referrals where the ToCH prioritiser determines a non-2 hour UCR triage outcome is appropriate, e.g. admission to a Community Assessment and Treatment Unit or Same Day Emergency Response.

The diagrams in Appendix 1 summarise the above for all 3 referral types (phone, Strata and web referral)

Scenario 1 – UCR referrals where the ToCH prioritiser determines a 2 hour UCR triage outcome is appropriate

Within 15 minutes of referral receipt, the ToC triager will discuss the referral with the referrer by phone. Where a 2 hour response is agreed, the ToC triager will source the care from community services and notify the referrer by phone of the outcome, including if there is no capacity available to provide a 2 hour response.

The table below shows how the referral should be recorded in RiO or Strata

Referral Type	Recording in Strata
Telephone referral	No need to create a referral on Strata – unless triage determines an urgent carers assessment is required – a UCR referral should be created using the Handling Urgent Telephone referrals SOP and sent on to the Independence and Wellbeing Service Receiver Service Record in RiO in line with the Cornwall Partnership NHS Foundation Trust Recording UCR guidance
Strata Referral	Complete the triage screen (Edit referral, triage) ADMIT the referral NB – Do not send the referral on to any receiver services unless triage determines an urgent carers assessment is required. Then a UCR referral should be created using the Handling Urgent Telephone Referrals SOP and sent on to the Independence and Wellbeing Service Receiver Service and immediately admitted.
Web referral	Save UCR referral as PDF using organisational naming convention. Do not convert to Strata referral. Email to UCR prioritiser and send Teams message to notify prioritiser that UCR referral has been sent and needs prioritising. After triage, record in RIO in line with the Cornwall Partnership NHS Foundation Trust Recording UCR guidance, uploading PDF as appropriate. Do not create a Strata referral unless triage determines an urgent carers assessment is required. Then a UCR referral should be created using the Handling Urgent Telephone Referrals SOP and sent on to the Independence and Wellbeing Service Receiver Service and immediately admitted.

Scenario 2 – UCR referrals where the ToC prioritiser determines a NON 2 hour UCR triage outcome is appropriate

Referral Type	Recording in Strata
Telephone referral	Create a referral in Strata for the right referral type e.g. Non-urgent/routine following the ‘Handling Urgent Telephone Calls SOP Manage as usual
Strata Referral	Complete the triage screen (Edit referral, triage) Change the referral type following the How to Change Referral Priority guidance. Manage as usual
Web referral	Save UCR referral as PDF using organisational naming convention. After triage, create a referral in Strata for the right referral type e.g. Non-urgent/routine following the ‘Handling Urgent Telephone Calls SOP. Upload the PDF UCR referral as appropriate. Manage as usual