Community React Team

Community React Team 

Information for GPs and other Health Care Agencies

• Author ID:           AM
• Leaflet Ref:         CRT 007
• Version:              2
• Leaflet title:         Community React Team
• Last review:        February 2023
• Expiry Date:        February 2025

Introduction

Community React Team (CRT) is a responsive service dealing with rapid issues requiring response within two hours.  The team comprises of different services whose aim is to reduce hospital admissions, ensuring patients are cared for at their place of residence. Referrals are made via clinical triage telephone 01942 481221.

CRT have medical responsibility for patients residing in Discharge to Assess  beds (D2A beds) and the medical cover of Jean Heyes Reablement Unit / Community Assessment Unit at weekends.

Hospital at Home

Hospital at home is one arm of CRT. It is a dedicated multi-disciplinary team consisting of occupational therapists (OT)/physiotherapists and nurses, providing rapid, same day holistic care in a community setting, aiming to prevent hospital admissions and facilitating early discharges from hospital.

The team receives referrals from various other services, including hospital, GP, community matrons, out of area hospitals, advanced clinical practitioners, district nurses and virtual ward. 

As a team, we provide various interventions:

• Intravenous Antibiotics
• Provision of equipment 
• Administration of sub cutaneous fluids
• Provision of support /care
• Venepuncture
• Monitoring of observations
• Blocked catheters
• Run bisphosphonate clinic in conjunction with christies
• Currently bridge packages of care while awaiting allocation by social care/reablement
• Wigan Reducing Long Lies Pilot (WROLL pilot) - which attends to patients who have fallen in their own home and receive a top to toe assessment to aim to keep them at home rather than conveying to hospital

Health Outreach and Inclusion Service (HOIS) 

The Health Outreach and Inclusion Service (HOIS) provides care to the most vulnerable communities in society and supports both individuals and families.  These groups include vulnerable migrants, the homeless, sex workers and the gypsy and travellers’ communities. 

These groups often have difficulty in accessing services.  HOIS ensure that healthcare needs are met within these vulnerable groups.  The service offers screening for Blood Borne Viruses (BBVs) and Tuberculosis (TB), Clinic in a box and screening for sexually transmitted infections (STIs).  The service is delivered at numerous locations within the community including patients’ homes, clinics and anywhere where support may be required for our vulnerable groups.  This also includes out-of-hours night shelters and on the street, when dealing with homeless clients.

Community Respiratory Team 

The Community Respiratory Team offers a multi-disciplinary team approach to management of chronic obstructive pulmonary disease (COPD), Interstitial Lung Disease (ILD) and Bronchiectasis throughout the Ashton, Leigh, and Wigan Borough.

The team consists of specialist nurses, physiotherapists and occupational therapists.

The service provides advice, information, treatment initiation, long-term management, and support services for adults with a confirmed respiratory diagnosis, as well as support for their families.

We offer a screening service for all patients who meet the referral criteria, including non‑respiratory patients.

We also case-manage patients who are prescribed oxygen, working in conjunction with the Hospital Oxygen Service at WWL.

Advanced clinical practitioners (ACPs) 8am-10pm

Advanced clinical practitioners (ACPs) can assess/diagnose and treat a variety of presentations in order to help keep patients at their place of residence and reduce hospital admissions.

Inclusive presentations are:

• Urinary tract infection
• Chest infection or pneumonia
• Pain affecting mobility
• Cellulitis and rashes
• Exacerbation of chronic obstructive pulmonary disease (COPD)

Clinical Triage Team

7 day service from 8am to 8pm

Clinical Triage is a central hub within the Community React Team, which comprises of clerical staff and nurses with a variety of skills and backgrounds. The team strive to liaise with other professionals from health and social care, also North West Ambulance Service (NWAS), to prevent admission.  Each referral is individually triaged to identify existing problems and then staff use knowledge and skills to forward the referral appropriately. 

The purpose of the triage team is to aim for admission avoidance and to work closely with secondary care to facilitate safe discharge.  The team triage a wide variety of referrals, e.g. IV antibiotics, from community therapy and community matrons, but this list is not exhaustive.  The team take referrals from all areas, including self-referrals.  The team have a vast knowledge of what is available locally and can signpost patients in the right direction.  Clinical triage also does follow-up telephone calls for patients discharged from hospital on pathway 0/1, which is patients seen as requiring no or little community input. We are heavily involved with the North West Ambulance Service (NWAS) and take referrals from NWAS to try and stop hospital admission.  Our current admission avoidance rate is 96%.

Blood Transfusion Team

The blood transfusion team are a small team of experienced nurses who carry out home transfusions for patients who cannot attend the planned investigation unit (PIU) at Royal Albert Edward Infirmary (RAEI).  It is a Monday to Friday service which runs 8am until 5pm. Their referrals are generated from the hospital, but the patient needs to be under the care of a consultant for this service. They carry out whole blood and platelet transfusions.  They also carry out regular group sessions and save samples to improve patient care by reducing the number of visits for different interventions.  The team often carry out 14 transfusions a week.