ParaDoc provides rapid assessment and treatment of acutely unwell patients who would otherwise be admitted. The focus is on elderly, frail and complex patients.  It also continues the morning Falls service for people who are on the floor.

ParaDoc comprises a GP with a Paramedic/EMT and may involve local rapid response/ Falls/Nursing/Palliative teams; Physiotherapists; Occupational therapists; Geriatricians; Social services etc to help manage people at home.

Advanced assessment and treatment equipment is carried along with a range of oral and injectable drugs, including End of life drugs.

The ParaDoc morning Falls Service comprises a senior Therapist (Occupational therapist or Physiotherapist) with a Paramedic. Patients will be critically assessed, helped up from their fall, and then given a full falls assessment, linking in relevant clinicians where required.  Urgent Carers and Care packages can also be accessed. Medical concerns will be discussed directly with the duty doctor.

The patient’s own GP will receive details of the visit.

Response time for Urgent cases  <2hrs.  Expected ETA’s are always discussed and agreed with the referrer.

Opening Times:

ParaDoc Falls Service: 0800 - 0000hrs 7 days a week

ParaDoc GP-Led Service 1200 - 0000hrs 7 days a week

Eligibility criteria

Inclusions

Patients aged 17 years and over who are temporarily or permanently resident in City and Hackney (including Nursing Homes and Residential Care).

Referrals are by telephone and all cases will be assessed and triaged in real time by the GP as part of the referral process. Multiple referrals will depend on triage and capacity.

ParaDoc takes referrals from the following groups following a clinical discussion:

Elderly patients with co-morbidities; Acute exacerbations of chronic conditions; Bedbound / End of life / Palliative patients; Acute confusion / Delirium; Reduced mobility / functional decline; Infections / sepsis; Breathlessness / COPD; Vulnerable patients / Social problems; Generally unwell / undifferentiated illness; Pain; Abdominal pain.

ParaDoc Falls Service will take referrals from the following groups following a clinical discussion:

Falls – on the floor; elderly patients with recent falls; Reduced mobility / functional decline; Vulnerable patients / Social problems; Patients requiring an increase in care; Patients requiring other therapeutic input – OT, Physiotherapy.

The full range of medical and urgent referrals seen by ParaDoc -and including the above- continues from midday until midnight.

Exclusions

Acutely unstable patients requiring immediate hospital admission; Patients with acute mental health problems as the primary presentation; Children.

How to refer

The following clinicians can refer to this service: GPs