Community Nursing - Bristol

Overview

Bristol’s dedicated community nursing teams provide healthcare and support to housebound patients in their home 7 days a week, between 8am and 7pm.

Community nursing teams provide a wide range of care and support:

• Coordinating care for patients with long-term conditions or complex health needs.
• Administering medication and supporting self-administration
• Dressing and managing wounds.
• Providing Catheter Care in Clinics and within the patient’s home
• Providing Wound Care for housebound patients after surgery.
• Supporting issues around continence.
• Caring at end of life.

The teams work in partnership with local healthcare professionals – for example GPs and other specialist community health services – to improve the health and independence of local patients.

By actively supporting those with long term conditions to manage their conditions in the comfort of their own home, the community nurses help to prevent hospital admissions.

Red Flags

Examples of urgent referrals:

• End of Life Patient in pain or distress
• Blocked Catheter
• Urgent Blood
• Patient at risk of admission to hospital due to long term condition, acute illness e.g. urine infection

Referral

This service is only available to housebound patients who are over 18 years old and registered with a GP in the Bristol area.

Provide any relevant details including: consent of patient, access or carer details, situation and background of problem, clinical reason for referral and expected outcome where possible. If Bloods are requested for housebound patients, advise which GP requires the results to be sent to and if there is a specific date for test to be completed.

Urgent referrals

Any new community nursing referrals that are deemed urgent (where a visit is required within 48 hours) must be made by phoning the SPA on 0300 125 6789.

Referrals to Rapid Response, Out of Hours Nursing, Urgent Therapy and COPD admission avoidance can also be made by contacting this number.

Non-urgent referrals

If the visit is not urgent, you should make a referral through EMIS Managed Referrals.

If your practice has not been configured to do this yet, a non-urgent referral form  must be filled in and emailed to sirch.bristolspa@nhs.net

Blood requests

Sirona has introduced a new approach to managing domiciliary blood requests.

Blood requests will be colour coded:

• Red: Required within 48 hours to avoid a hospital admission, to ensure safety, or to implement a change of treatment. Please note these can only be phoned through to SPA on 0300 125 789. You cannot complete a form or make a referral through EMIS to request them.
• Amber: Bloods required between 48 hours and seven days.
• Green: Bloods required between eight days to six weeks.

The requester is responsible for following up and completing any actions.

The new Sirona Community Services Domiciliary Bloods Referral Form is live on EMIS for the request of Amber or Green bloods.

Referral contact details

Once you’ve made a referral through SPA you can ask to be put through to the specific Community Nursing Team or if you wish to speak directly to a specific Community Nursing Team about a patient on their caseload or use the contact details.

Use the ‘Community Nursing Patient Allocation’ tool as the teams work geographically, to identify which team you need to speak to:

Team Coordinators have oversight of each team's caseload and they are the best people to answer any queries you may have. You can speak to Team Coordinators Monday to Friday 8am - 7pm, to discuss a patient on their caseload. These numbers are:

• Shirehampton Community Nursing Team: 07796 337875
• Horfield Community Nursing Team: 07767 653285
• East Trees Community Nursing Team: 07900 264389
• Fishponds Community Nursing Team: 07554 770616           
• Knowle Community Nursing Team: 07899 065459           
• Amelia Nutt Community Nursing Team: 07786 023386

End of life care - community support

Please see End of life care - community support

Wound Care

Please see Tissue Viability / Wound Care Service

EMIS electronic prescribing charts

Community prescribing medication charts can now be completed electronically in EMIS (BNSSG Community Drug Chart), without the need for a wet signature. There is now a single version for BNSSG.  For a PDF version of the chart, see BNSSG Joint Formulary

Community Insulin prescribing charts can also be completed electronically in EMIS (BNSSG Insulin Community Drug Chart), without the need for a wet signature. There is now a single version for BNSSG. For a PDF version of the chart, see BNSSG Joint Formulary

Prescribing of end of life medication should not be done on these charts - these charts are available separately here.

The process we have agreed for the electronic drug chart use is:

For new referrals:

1. GP or other primary care healthcare professional identifies patient will need an intervention requiring a PSD and completes consultation accordingly documenting fully on EMIS.
2. GP completes community prescribing form on EMIS.
3. For urgent requests within 48hrs, the GP/HCP completes a referral to the Sirona SPA by phoning 0300 125 6789 and will advise the Health Navigator that the chart has already been uploaded to EMIS.
4. For routine requests over 48hrs, the GP/HCP completes a referral to the Sirona SPA by email or managed referral using the single referral form and stating that the chart has already been updated to EMIS. The email address for referrals is: 
   • Bristol – sirch.bristolspa@nhs.net
   • South Glos – sirch.southglosspa@nhs.net
   • North Somerset – sirch.northsomersetspa@nhs.uk
5. SPA will process the referral and may call the surgery back for further information if required- please ensure that all forms are fully completed
6. Sirona staff in the community will print the chart(s) and use according to agreed process

For updated charts: (requested by INT colleagues when things change or charts are due to expire and need updating)

For urgent requests, community staff may telephone the surgery, or otherwise will email the surgery receptions generic email address.

When contacting the surgery, they will need to provide:

• Individual details – patient name, DOB/NHS number, medication requested and why
• Any further useful information
• By when does this need to be prescribed (deadline)?
• Contact details to confirm this has been done – return phone number and/or email address.

The surgery will then arrange for the chart to be completed by a prescriber and uploaded to EMIS and will email or phone the community team using the details provided to confirm that this has been done and the chart is available to print and use.

For secondary care and other providers not on EMIS the charts should be sent to sirona.psd@nhs.net with all the relevant information attached.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.