West Essex Frailty Pathway: UTI NB Asymptomatic bacteruria in older people is common . Do not routinely perform dipsticks on asymptomatic patients or based on urine appearance / smell with no symptoms **For catheterised patients only send CSU for culture if clinical signs /symptoms of suspected UTI are present or sepsis with no alternative identifiable source Follow diagnosis and management of suspected UTI in older people as per West Essex CCG guidance pathway Review response to treatment with oral antibiotics as per local policy guidance Failure to improve or evidence of mild deterioration /mild delirium/reducing mobility or inability to complete oral therapy or resistant bacteria is only responsive to IV medication or social factors complicating management at home. YES NO Use EWS News Score to assess severity Are red flag symptoms present? Signs of overwhelming sepsis? Significant hypotension? Severe persistent drowsiness? Review and assess for clinical improvement . Complete course of oral therapy YES NO NEWS Score ≥ 5 RR Tachycardia SBP <90. Admission to acute hospital NEWS Score 1-4 Consider urgent assessment via RAC or admission for step up care in community beds for multidisciplinary assessment, consideration for IV antibiotics and or rehabilitation SPA contact Monday to Friday 8am – 5pm for arranging admission Single Point of Access (SPA) 08:00-21:00, Seven days a week Telephone: 01279 827524 Fax: 01279 827827 Email: sep-tr.SinglePointOfAccess@nhs.net