{"id":4493,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/unscheduledcarelucs\/"},"modified":"2024-12-02T12:01:17","modified_gmt":"2024-12-02T12:01:17","slug":"unscheduledcarelucs","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/admissionsurgentcare\/unscheduledcarelucs\/","title":{"rendered":"Unscheduled Care (LUCS)"},"content":{"rendered":"\nUnscheduled Care (LUCS)<\/title>\n\n\n\n<h4 class=\"wp-block-heading\">Overview<\/h4>\n\n\n\n<p>The Lothian Unscheduled Care Service (LUCS) provides out of hours \nprimary medical services to the NHS Lothian population during times when\n GP practices are closed (i.e. weekends, evenings, nights and public \nholidays).  We offer a home visiting and appointment only service at \nPrimary Care Emergency Centres (PCEC) from five geographical locations \nacross NHS Lothian (Midlothian Community Hospital, East Lothian Community\nHospital, The Royal Infirmary of Edinburgh, The Western General Hospital\n and St John’s Hospital), with initial assessment and triage being \nundertaken by NHS24 (111), which is a nurse-led 24-hour \nhelpline operated by the national special Health Board that is NHS24.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Information Sharing<\/h3>\n\n\n\n<p>\nIn order to provide high-quality, safe and effective care to the NHS \nLothian population, it is often useful for ‘in-hours’ primary care \ncolleagues to share information with NHS24 and LUCS.  There are several \nways to do this:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Palliative Care Summaries<\/strong>\n<ul class=\"wp-block-list\">\n<li>For patients receiving palliative care, information can be shared with patient consent (see below) using the Key Information Summary (KIS) palliative care template (PCS).  If the patient mentions that they are receiving ‘palliative’, ‘terminal’ or ‘end of life care’ when their call is answered by NHS24, they will receive an expedited outcome.  Their PCS will be immediately visible to NHS24 and LUCS.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Anticipatory Care Plans<\/strong>\n<ul class=\"wp-block-list\">\n<li>For patients who have care needs which can be anticipated (such as those with multi-morbidity or chronic conditions such as COPD) and who have an anticipatory care plan (ACP), information can be shared with consent using the Key Information Summary anticipatory care free-text box.  The following NHS Lothian intranet site provides additional information on ACPs:<a rel=\"noreferrer noopener\" href=\"https:\/\/eur01.safelinks.protection.outlook.com\/?url=http%3A%2F%2Fintranet.lothian.scot.nhs.uk%2FDirectory%2FAnticipatoryCarePlan%2FPages%2FACP%2520Landing%2520Page.aspx&data=05%7C01%7CHeather.Levy%40nhslothian.scot.nhs.uk%7C7eef4b4773c04fbbf50d08daf962555a%7C10efe0bda0304bca809cb5e6745e499a%7C0%7C0%7C638096497967403346%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=PSYpXyulH6b9ec1uBPxXj3Vw5PfWaEZZ2%2BurAxUz4nc%3D&reserved=0\" target=\"_blank\">Anticipatory Care Planning (ACP) (scot.nhs.uk)<\/a> .  NHS24 and LUCS are able to immediately access the contents of the patients ACP.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Special Notes<\/strong>\n<ul class=\"wp-block-list\">\n<li>For patients where specific, potentially time limited, information is likely to be valuable to either NHS24 or LUCS, a special note can be sent with patient consent using the Key Information Summary.  It is important that special notes are given an appropriate expiry date, so that once no longer relevant, they stop being visible to NHS24 and LUCS.  A special note can be ‘never expiring’ if it is deemed that the information it contains will always be relevant for that patient (such as persistent communication or hearing difficulties).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Planned Review Service<\/h3>\n\n\n\n<p>LUCS\u00a0also offers a planned review service (PRS), which aims to support ‘in-hours’ colleagues provide ongoing urgent primary-based care to patients during the out of hours period.\u00a0\u00a0 A planned review service referral pro-forma is available on\u00a0SCIGateway under the ‘Out of Hours Hub (WGH)’ domain and must be completed and sent by 2100h (Monday to Friday).\u00a0 Out with these times, Sci Gateway is NOT checked by the LUCS Hub.\u00a0 Please phone LUCS Hub on the \u2018professional only\u2019 line 0131 537 2703 if you have a late notification for LUCS.<\/p>\n\n\n\n<p>The planned review service is phone based initially, so it is \nimportant that the patient is told that one of the out of hours doctors \nfrom LUCS will phone them as close to the time specified in the referral\n sent to us.  After the LUCS GP phone assessment, we may decide that a \nhome visit or a PCEC appointment is required (with or without LUCS \ntransport being arranged) for further assessment and a decision on \nongoing management.  We may also plan to re-contact the patient by phone\n during the unscheduled care period if deemed appropriate.<\/p>\n\n\n\n<p><strong>Consent<\/strong><\/p>\n\n\n\n<p>Although best practice is to discuss all planned information sharing \nwith patients, consent can be over-ridden for all parts of the KIS \n(special notes, ACP and PCS) if indicated.  This is recorded by using \nthe ‘KIS Consent Declined’ tick-box, then the ‘Override Consent’ \ntick-box, and selecting the relevant drop down-menu choice (legal \nrequirement; vulnerable person; risk to self; risk to others).  It is \nalso possible to record whether the patient is aware of consent being \nover-ridden by using the ‘Patient Aware of Override’ tick-box and \nadding additional explanatory free-text notes.<\/p>\n\n\n\n<p>Over-riding consent is important where staff or patient safety is at \nrisk (i.e. with patients known to be violent or aggressive), or in \npatients who are deemed to be vulnerable.  Consent can also be \nover-ridden because the patient is unable to give this on the grounds of\n capacity (i.e. dementia, learning disability, young children at risk), \nbut where information sharing is likely to be in their best interest.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Unscheduled Care (LUCS) Overview The Lothian Unscheduled Care Service (LUCS) provides out of hours primary medical services to the NHS Lothian population during times when GP practices are closed (i.e. weekends, evenings, nights and public holidays).  We offer a home visiting and appointment only service at Primary Care Emergency Centres (PCEC) from five geographical locations across NHS<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3683,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[36],"class_list":["post-4493","page","type-page","status-publish","hentry","category-unscheduled-care-lucs"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/unscheduled-care-lucs\/\" rel=\"tag\">Unscheduled Care (LUCS)<\/a>","rttpg_excerpt":"Unscheduled Care (LUCS) Overview The Lothian Unscheduled Care Service (LUCS) provides out of hours primary medical services to the NHS Lothian population during times when GP practices are closed (i.e. weekends, evenings, nights and public holidays).  We offer a home visiting and appointment only service at Primary Care Emergency Centres (PCEC) from five geographical locations across NHS","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4493","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4493"}],"version-history":[{"count":6,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4493\/revisions"}],"predecessor-version":[{"id":21729,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4493\/revisions\/21729"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3683"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4493"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4493"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}