There's a discharge planning nurse who may or may not work with the hospital social worker. As many of us know, it's important for relatives to flag up problems to both these jobholders when we feel a discharge home (or to previous accommodation) wouldn't be safe. Desperate NHS staff may be too ready to send home someone vulnerable to clear a bed for another patient who's in dire need of it.
Would PLEAD with you all to check out the draft NHS Sustainability & Transformation Plans (STPs) for your area.
nitram has provided details of which areas are covered by STPs in the thread I started on STPs.
These local plans have the common thread of closing acute and community hospitals, selling off the sites and pushing healthcare onto the GPs (who are in no state to take up the slack - they're hard pushed to keep primary care going as it is, they can't take on the workload the hospitals used to carry out and they haven't got the kit, buildings or training to do so). My area's
plan is fairly typical - planning to close one in 3 of our acute hospitals (including a national centre for kidney disease and urology) and 2 of our community hospitals and to push the work onto GPs (in spite of press articles from GPs saying they've reached crisis point, can't recruit new doctors, have GPs wanting to retire but unable to ... and all the rest of it).
Our plan says optimistically that the patients no longer able to access hospital beds will be cared for in their own homes. I'm wondering just how the many patients in the early stages of dementia are going to manage the new challenges of self-caring while they convalesce from moderately severe infections, cancer and the like.
I'm also wondering how such patients and others can be expected to cope at home when the home accommodation isn't fit for the purpose. When my Mum had broken several vertebrae and was simultaneously well advanced in dementia, unsteady on her feet, unpredictable, sometimes violent, averse to taking medication and doubly incontinent how was my Dad to provide safe care when there was no accessible downstairs loo or bathroom? The only safe, best and cheapest answer was to give Mum a bed in the community hospital - already a rare resource, now to become much rarer.
There are
millions of patients and carers dependent on receiving at least the same level of NHS services as we've got now. I dread to think what will happen to all of us if these service levels are reduced.