3 minutes with Sophie Wallington, crisis response team

Crisis response is an extremely varied, fast-paced and interesting service to be a part of and I knew that it would challenge and develop me as a clinician. The opportunity to undertake the MSc in advanced practice and work as a trainee in the service has given me with an excellent grounding in urgent care medicine in the community. 

 

I believe, similar to all roles in healthcare, being committed, hard-working and compassionate are essential. However, to work in our team resilience and creativity also help. We all have a great sense of humour and everyone is so supportive of each other. While physiotherapists have all the required skills to excel as advanced practitioners, I did need to peer beyond the traditional scope of my practice and incorporate traditional nursing and medical clinical skills into my work. 

 

We provide health and social care to patients in our community who are reaching a crisis point, that previously would have presented at urgent care or been placed in 24-hour care. We respond to a wide range of issues and problems within two hours.  Examples include assessing patients following a fall at home not requiring hospital care, patients with chest and urine infections who require clinical monitoring and support, and episodes of carer breakdown where urgent social care intervention is needed to prevent crisis and reduce risk.

 

Our patients are typically older people, but we have a challenging and diverse patient population in north Manchester with the impact of multiple long-term conditions affecting patients of all ages.  The team is comprised of advanced practitioners with me as a trainee, a senior physiotherapist, senior occupational therapist, senior nurses, social workers, assistant practitioners and pharmacists.  We have great support from our service manager, a dedicated admin team, and clinical supervision sessions from our GP. We operate from 8am to 8pm, seven days a week, 365 days a year.     

 

Mobility and function are more often than not affected by any acute insult or illness in our patient population, early specialist therapy assessment is essential to minimise risk and optimise independence and function. Physiotherapists often view situations and assess patents in a different way to other colleagues. Our skills, used alongside nursing or social work skills, for example, really give our patients complete assessments and care quickly. We have advanced nurse practitioners with specialist backgrounds in mental health, surgical and critical care, acute medicine, vascular medicine and complex management of long-term conditions in the community. Adding an advanced practitioner with a physiotherapy background to this skill mix offers advanced clinical decision-making for musculoskeletal pathologies, rehabilitation and pain management. 

 

One of the aspects of my role is to act as frailty champion for North Manchester Community Services, and the work we have been doing on frailty assessment and community care pathways over the last two years has been really exciting. A true research and development success story, we have used frailty screening to understand our patients’ needs much better and been able to deliver much more appropriate care. 

 

Our service is thrilled to be the first non-GP service in north west England to accept ‘amber divert’ patients directly from the ambulance service, as an alternative to transferring them to A&E. We have recently gone live with this initiative and already the level of acuity and the variation in presenting problems that are being referred to us is growing. We are all excited by how our range of skills is already developing.