Intermediate care services

This is a tier of services which offers both bed-based and communitybased services, ie community beds, specialist care centres and the intermediate care team.

ICT also has a team of nurses in the accident and emergency department who can assist you to return home quickly.

You may not be able to return home immediately because of practical difficulties or important decisions that need to be made about your future. Unfortunately the hospital is unable to accommodate you during this process, as we need to provide care for other patients in need of urgent treatment. In some cases the daily multidisciplinary team (MDT) meeting may recommend a period of rehabilitation in order to maximise your independence and enable you to live at home as independently as possible. In this case you will be referred to a community bed. An assessor from the community hospital will ensure you fit the criteria if it is for a medical rehabilitation bed. You will be transferred to the first available bed which may not necessarily be the one closest to home. In the Discharge To Assess process all patients who are unable to go to their permanent place of discharge are transferred to a bed in the community, at centres that have been identified for this process. This will enable all patients who are ready to leave an acute hospital bed to be discharged sooner and therefore reduce the risk of a prolonged length of stay. There are also intermediate beds for reablement in a social setting which are called specialist care centres. These centres provide a period of reablement up to six weeks where medical needs are not required. There are three centres in the county (as at October 2015) and you will be expected to go to the first available bed, wherever that may be. Other beds may be available in the community at a later date.

Intermediate Care Team (ICT)

The ICT is a specialist community-based team of qualified nurses, therapists and doctors that provides comprehensive assessment, treatment and rehabilitation to enable you to return home and continue your recovery following your stay in hospital. (You can benefit from this service even if you live in a residential or nursing home.) As your ‘hospital at home’, ICT provides high quality, intensive healthcare up to a maximum of two weeks following discharge from hospital, bridging the gap between the hospital team and your GP. In the event that you become unwell following discharge, ICT can access a range of other options to prevent you being re-admitted to hospital unnecessarily. ICT staff will work with you to design a personalised short-term treatment plan for your rehabilitation at home. This may include complex medical treatment for a range of health conditions as well as improving your strength, stamina and confidence with a range of activities that will help you live independently. If you also require social care support, ICT will arrange for the short term and reablement team (START) or the crisis response team (CRT) to provide this for you, alongside your ICT treatment plan. ICT also has a team of nurses in the accident and emergency department who can assist you to return home quickly. Ask a member of the hospital team to contact ICT for you. For more information, please ask the NGH ward team for the ICT leaflet, which provides further details on what we are able to provide for you. More information is also available by telephoning 0300 777 0002 (option 1) or online at: www.nhft.nhs.uk/ intermediate-care-team