Download Referral Process to the Step Up Step Down Unit

Step Up Step Down Unit
ADMISSION CRITERIA
All patients will be assessed on an individual basis.
Inclusion Criteria for Step Up from Home or A&E
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A GP or Other Health Care Professional has been to visit the patient at home
and undertaken an assessment of needs and completed a unit referral form.
(Attached)
A&E doctor has seen and assessed the patient and completed a unit referral
form. (Attached)
It has been established that the patient does not require acute investigation or
treatment within an acute hospital setting.
An initial diagnosis ie Chest infection, Urinary tract infection, dehydration, fall
has been established
An assessment has been made that the patient has the potential to return to
pre morbid function with intensive short term support from the unit staff.
The patient is not able to be supported in the home environment to receive
community rehabilitative or care services
The individual has been provided with information about the Unit and the
ethos of rehabilitation, consents to admission and is willing to participate in
the rehabilitation process.
The patient is registered with a GP in Bexley
The patient is aged 18+
Exclusion Criteria
 Patients who are medically unstable and require diagnostic, medical and
nursing support of an acute hospital service
 Patients whose rehabilitation and care needs can be supported in their own
home.
 Individuals who require interim or respite care.
 Individuals awaiting care home placement, social services support e.g. house
clearance/cleaning or adaptation.
 Individuals with cognitive or mental health problems that could not be
managed within the unit. For example unable to retain information,
wandering, behavioural disturbances or meant that they could not participate
in the rehabilitation offered within the unit.
Due to the nature of each individual patient being assessed as acceptable or
unacceptable for admission to the Unit, the final decision must lay with the
nurse in charge of the shift. This decision maker will need to take into account
the patients current medical condition, their rehabilitative potential, can the
individuals needs be met and current patient dependency.
Step Up Step Down Unit Referral Form
To refer a patient to the SUSD unit, please contact the Central Booking
Desk on 020 8319 7155.
Fax number : 020 8319 7157 (secure fax)
PATIENTS NAME
Date of birth:
/
/
NHS no:
Patients address
Ethnicity code
Telephone number
Post Code
NEXT OF KIN NAME
Relationship to patient
Address
Telephone number
Home
G.P. Name
Mobile
Surgery address
Surgery telephone number
About this admission
Diagnosis
Plan of treatment required
Step Down Ward
Past medical history
Social care/community health care services currently being received. I.e. social worker /District Nurse
/CPT/CHRT:
Please give contact details if available
What assistance does the patient need with daily
living? i.e. with .
Administering medication
Dossett
yes  no 
Prompting
yes
 no 
Mobilising
Independent

Stick

Frame

Washing
Independent

With help

Dressing
Independent

With help

Communicating
Glasses
yes
 no 
Dentures
yes  no

Hearing Aid yes
 no

Others
Please list all patients regular medications
Please list any new medications prescribed
within the last week ie antibiotics etc
ANY OTHER RELEVANT ADDITIONAL INFORMATION
Has the referrer explained that this is a short stay, rehabilitation unit to the patient
Yes
No
Name of referrer
(please print)
Designation
Contact address
Telephone number
Signature………………………………….. DATE:
TIME:
FAILURE TO COMPLETE ALL THE FIELDS WILL RESULT IN DELAYS
For completion by SUSD staff
SUSD Nurse time referral received
Accepted
Date and Time patient arrived on unit
SUSD Nurse Signature
Please print name
hrs
Please tick
Declined
Reason :
/
/
at
hrs