Expert teams of emergency medics are taking the Emergency Department to the patient in rapid response cars across North East London, forming a vital part of the capital’s Covid19 response.
The Physician Response Unit (PRU) is a collaboration between London’s Air Ambulance, the London Ambulance Service and Barts Health NHS Trust. It is staffed by a senior emergency medicine doctor and an ambulance clinician, and carries advanced medication, equipment and treatments usually only found in hospital. The service responds to 999 calls, treating patients in their homes who would otherwise have often required an ambulance transfer to hospital.
Since Monday 6 April, the PRU service is now operating with two cars and its operational hours have been extended to run from 8.30am to 11pm seven days a week.
The Covid-19 pandemic means that the NHS across the capital is responding to the biggest global health threat in a century while also ensuring that people who don’t have the virus can still access the other services they need in as safe a way as possible. In response to this, the PRU has also established new ways of working to provide care for more patients in their own homes.
- Enabling early discharge from Emergency Departments – ED clinicians in the Royal London, Whipps Cross and Newham hospitals may discharge a patient in order that they are visited at home by the PRU rather than referred for inpatient care
- Saving vulnerable/ at risk patients a trip to hospital – PRU teams can be tasked to visit patients that are ‘high risk’ for instance cancer patients on chemotherapy that would otherwise need to come to hospital for assessment. They are able to perform an advanced assessment, do blood tests and other investigations, and administer treatments, all in the patient’s home.
- Taking referrals from inpatient wards – the PRU has created a consultant rota so that ward teams can discharge patients that they would normally have to keep in hospital, but can now be discharged with the safety net of a review by the PRU in the community
- Supporting palliative care services – palliative care teams at St Joseph’s Hospice and The Margaret Centre can liaise with PRU for them to visit and provide community review or clinical consultation, when otherwise patients would need to be taken to hospital by ambulance.
These measures will free up hospital beds and reduce risks for vulnerable patients by helping them avoid a trip to hospital.
In addition, the PRU is offering assistance to the London Ambulance Service to help with transfers of unwell Covid-19 patients to the Nightingale Hospital. This undertaking will support the large-scale Nightingale project being orchestrated by NHS services across London and will offer the ambulance service additional support at a time when it is facing huge pressure from 999 and 111 calls across London.