SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

The urgent care centre should ensure patients receive a consistent and rigorous
assessment of the urgency of their needs and an appropriate and prompt response
The urgent care centre information and communication technology processes should
be inter-operable with both GP and Trust systems in order to facilitate effective
information sharing.
The main elements of the service will include streaming, registration and initial assessment;
diagnosis and treatment; and referral and discharge.
8.15. Clinical scope
Figure 8.23 summarises the urgent care centre clinical exclusion criteria for adult and
paediatric patients (please see the Chapter 7b for a more detailed list of exclusion criteria).
Many of the clinical exclusion criteria listed in Figure 8.23 will only be identified after clinical
assessment. As a result, it will not always be possible to apply these criteria at the point of
streaming. Some patients may therefore be identified as unsuitable for the urgent care
centre during assessment or treatment.
The E&UC CIG has developed a detailed transfer protocol to ensure that patients assessed
to be out of scope for the urgent care centre can be transferred to a more intensive setting of
care safely.
Figure 8.23: UCC clinical exclusion criteria
Conditions suitable for UCC Clinical exclusions (adults) Clinical exclusions (children)
The scope of the UCC will
include both Minor Illnesses
and Minor Injuries:
o cuts and grazes
o minor scalds and burns
o strains and sprains
o bites and stings
o minor head injuries
o ear and throat infections
o minor skin infections /
rashes
o minor eye conditions /
infections
o stomach pains
o suspected fractures
The interpretation of X-rays
and other diagnostics/
investigations will be in
scope
The treatment of Minor
Fractures will be in scope.
Interventions considered inscope
include:
o the manipulation of
uncomplicated fractures
o non-complex regional
anaesthesia for wound
closure
o incision and drainage of
abscesses not requiring
Markedly abnormal baseline
signs
Chest Pain (likely cardiac)
Complex fractures (e.g. open
fractures, long bone fracture
of legs, spinal injury)
Patients receiving
oncological therapy
Sickle cell crisis
Acute Shortness Of Breath
(inc. severe shortness of
breath compared to normal,
cyanosis, increased
peripheral oedama)
Signs of severe or life
threatening asthma
Airway compromise
Acute exacerbation of heart
failure
Burns (> 5%; facial/eye;
inhalation,
chemical/electrical)•New
CVA
Significant DVT
Temporarily unable to walk
Haematemesis/ Haemoptysis
Overdose / Intoxicated and
not able to mobilise
Acute psychosis / neurosis
Significant head injuries
In addition to the adult
exclusion criteria:
Acutely ill children (defined
using PEWS)
Paediatric head injury
Procedure requiring sedation
Multiple pathologies deemed
to be complex
Repeat attendances: 3
attendances in 3 months
Fever with non-blanching
rash
Fitting
History of decreased or
varying consciousness
Combination of headache,
vomiting and fever
History of lethargy or
floppiness
8d. Urgent care centres 254