Download RACOP - Royal Berkshire Hospital

Guide to RACOP for General Practitioners
Rapid Access Clinic for the Older Person (RACOP)
Service
The remit of this service is to offer multi-disciplinary specialist assessment to older people in the form of
Comprehensive Geriatric Assessment (CGA).
The service treats older people who need to be seen quickly in order to prevent hospital admission or who
require:

medical and/or multidisciplinary (physiotherapy, occupational therapy) assessment and/or treatment

assessment of rapid onset of Frailty syndromes such as confusion and/or urinary incontinence

blood transfusion, iron infusion, or management of acute hypercalcaemia.

other problems which would benefit from urgent assessment by a geriatrician and MDT.
Location
We are based in Inpatient Therapies on Level 1 of Battle Block at the Royal Berkshire Hospital.
We run the clinic on Monday, Wednesday, Friday mornings and Tuesday afternoon (and sometimes on
Thursdays when Dr Pearson is away and our Falls Clinic is cancelled). We accept referrals from General
Practitioners, Community Matrons and the Emergency Department.
Referrals
(New referral process from 3rd August 2015)
Referrals are preferably made by telephone conversation with the registrar or consultant covering RACOP.
This can be done from 8.30-16.30 via switchboard (0118 3225111) and then asking for bleep 510. In this
way patients can be seen on the next working day if necessary. Referral letters should then also be faxed to
0118 322 6704. In the unusual circumstance the doctor cannot be reached, the clinic can be contacted on
0118 322 6547, where a member of staff can take a message.
If you have a specific clinical question you would like an answer for, please indicate this in the referral letter.
If the referral is for a blood transfusion please specify whether investigation of the cause of the anaemia is
also required. Please consider if the patient needs to be accompanied by his/her chosen companion.
Please be sure to supply us with correct contact details for the patient and/or next of kin, and inform them the
clinic will be in contact to arrange the time.
Attending the Clinic
The duration of clinic visits vary depending on the nature of the assessment and treatment required. Please
be aware that the visit could last approximately 3 hours (longer if blood transfusion required). Light
refreshments are provided as required.
Transport, if required, should be arranged by the GP surgery, allowing up to 3hrs for a standard RACOP
appointment and up to 6-7 hours for those requiring blood transfusion.
Dr Paul Wearing, Elderly Care Department 2015
1
RACOP
July 2015
Investigations
It is helpful if relevant blood tests are arranged by the GP before the RACOP visit. This prevents patients
having to wait after their appointment for the results of blood tests sent from the clinic. Patients who require
blood transfusion need to have appropriate samples collected before their appointment so that they can be
crossmatched. Please see the Blood bank guidelines, specifically noting the need for two samples, the most
recent of which needs to be within three days of the planned transfusion.
The nursing staff will see the patient on arrival and perform baseline observations and can take blood if
necessary. We can arrange basic radiology investigations. We may be able to arrange same-day CT scans
following discussion with their department. Other tests such as MRI, cardiology investigations are normally
requested as an outpatient.
Unsuitable patients
To attend the clinic, patients need to be able to transfer with the assistance of one person. We are unable to
see patients who are bedbound. It may be more appropriate for these patients to be seen by one of our
Community Geriatricians as a domiciliary visit.
Patients, whose sole problem is falls, should be referred to the Falls Clinic. The exception to this is if they
need to be seen urgently, when RACOP may well be appropriate. At the Falls Clinic, patients will have a
multidisciplinary assessment under Dr Pearson’s supervision. Referrals can be made via Choose and Book,
or by faxing a referral to the elderly care secretaries (0118 322 6544) or the clinic. Patients whose main
problem is chronic cognitive impairment should be referred to the memory clinic.
We have Elderly Care outpatient clinics at the Royal Berks and in Bracknell. These are very appropriate for
less urgent queries and the wait time is quite short. Referrals are again via Choose and Book, or by sending
a referral to the elderly care secretaries.
Clinic Letters
The doctor who has seen the patient will type a clinic letter on the same day as the clinic; this will be posted
to the GP. This should detail our management plan and any recommendations for our colleagues in Primary
Care. We will review any requested investigations and either arrange follow-up or contact the patient with the
results.
Contact details
Royal Berkshire Hospital switchboard
0118 322 5111
RACOP bleep
510
RACOP phone
0118 322 6547
RACOP fax
0118 322 6704
Elderly Care secretaries fax
0118 322 6544
Dr Paul Wearing, Elderly Care Department 2015
2