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QI case study: Mobilising urgent response
- QI Case Studies
- QI Improving Patient Experience and Outcomes
What is a QI Case Study?
Case Studies invite you to explore invaluable insights through a collection of compelling improvement projects from across the Trust. Read below for a Deep Dive into how the Luton Rapid Response team developed their UCR service.
Improvement Name: UCR Mobilised - Accelerating urgent community response
Date: January 2024
Deep Dive: Understanding the Problem
The challenge:
The need for urgent care is surging, hospitals aren't always the best option with increased risks of infections, loss of function, and a loss of independence, particularly for the elderly. Long ambulance waits, A&E delays and pressure for hospital beds mean our healthcare system is under immense pressure.
Investigation of current pathways:
Process mapping of the current pathways revealed inefficiencies, risks and opportunities for streamlining processes. It also highlighted the limitations of existing data reporting procedures.
Unveiled data insights:
Analysed demand, capacity and staffing needs for the 2-hour target.
Engagement:
Workshops, A&E shadowing, ambulance control room visits, audits and GP discussions were held.
Workforce development:
Identifying gaps in required skills.
Learning:
Gathered and reviewed learning from best practices from the 'accelerator' sites.
Design: Designing the Change
Staff participated in workshops to redesign internal referral processes, and align on pathway criteria and conditions, and several partner meetings were held to collaboratively shape pathways. A pilot test proceeded to full implementation, and additional funding was secured for expanding the UCR service.
Deliver:
Our UCR service launched in 2022 and has consistently achieved the maximum response time of 2 hours for people identified as needing and appropriate for community support. We achieved this by...
Streamlined pathway and clear roles: We enhanced referral and triage pathways, making roles and responsibilities clearer while increasing efficiency.
Innovative care and support: Multiple new care pathways, including health checks, call-before convey, and falls referrals, have revolutionised our response to urgent needs.
Dedicated UCR phone line: To further expedite service, we established a specialised UCR phone line, managed by our UCR clinicians.
Enhanced monitoring: Our UCR data dashboard provides effective performance monitoring, ensuring continuous improvement.
Strengthened workforce: We reviewed and updated job descriptions, enhanced recruitment, and implemented new staffing arrangements to align with service delivery. Enhanced skills of the team through a tailored training programme.
Introduction of the UDR Coordinator role for team support.
Comprehensive resources: We developed essential resources such as Standard Operating Procedures (SOPs), guidelines, and care plans to support our new pathways.
Benefits/Successes:
- 2,171 patients were referred to UCR (potential hospital admissions avoided) in 2022.
- 89% of patients were seen within 2 hours (by December 2022 98% of patients were being seen within 2 hours).
- 66 ambulances were saved in the first 3 months since access to the 999 stack was implemented.
- Increased UCR capacity 8 am-10 pm, 365 days a year.
- Improved patient outcomes and experience.
- Increased awareness of UCR offer across the system
- Improved data reporting across the service
- Built great relationships with system partners through collaborative working - which strengthened other areas wider than UCR work.
- Upskilling/development of staff.
Evolve: Continuous Improvement
Post-implementation and feedback sessions were held to capture learning and areas for ongoing improvement.
Lessons Learnt:
- Building trust amongst referrers takes time - referrals are still limited.
- Recruitment is ongoing but slow, with an emphasis on building a sustainable workforce.
- Collaboration is essential for pathway development, involving relationship-building and role understanding.
- Support from senior leaders, the ICS level, and the national team has been vital for maintaining momentum.
- Limited system data makes it challenging to demonstrate pathway impact.
You can find more information about Luton Rapid Response team and their case study below.
Download the full Case Study here
If you'd like to dive into more examples of projects, head to our Case Studies page for inspiration.
Last reviewed:
1 March, 2025