7 - Community Medicine Flashcards
What is the role of community hospitals?
- Health promotion
- Diagnostics,
- Rehabilitation
- End of life care
- Minor injuries unit
What is NHS continuing healthcare?
When people with long-term complex health needs qualify for free social care arranged and funded solely by the NHS
If you are not eligible for NHS continuing healthcare, you can be referred to your local council. If you still have some health needs then the NHS may pay for part of the package of support. This is sometimes known as a “joint package” of care.
How are patients assessed by the CCG to see if they are eligible for NHS continuing healthcare?
Initial checklist assessment: used to decide if you need a full assessment, completed by nurse, social worker or doctor.
If don’t pass then not eligible
Full assessment to see if eligible: done by MDT looking at lots of parameters (see image) and scoring them “priority”, “severe”, “high”, “moderate”, “low” or “no needs”
Fast Track Assessment: if terminal, package of care done in 48 hours rather than 28 days
If 1 priority or 2 severe then usually eligible
How often is NHS continuing care reviewed?
- Takes 28 days to put into place
- 3 month review
- Annually thereafter
What is Discharge to Assess?
A.K.A ‘home first’, ‘safely home’, ‘step down
Pt is sent to a care home so their needs can be assessed and NHS continuing healthcare can be done from the care home
What are the different pathways in Discharge to Assess?
What is the definition of the following:
- Continuing Care
- Nursing Home Care
- Residential Care
- Intermediate Care
- Interim Care
- Continuing Care: is a fully-funded package of care that some people are entitled to receive as a result of disability, accident or illness
- Nursing Home Care: Personal care but always 1 or more qualified nurse on duty to provide nursing care
- Residential Care: No medical staff on site, just help with personal care, lower level of care than above
- Intermediate Care: Free short term service in your own home after acute hospital stay or fall. Includes physios, OTs etc. More rehabilitation
- Interim Care: Patient ready to be discharged from hospital but family are not sure about long-term care yet as patient has developed more health needs so can have short time of help
What is the concept of rehabilitation?
Multidisciplinary set of interventions to restore functional ability or enhance residual functional capacity
Reduces the negative impact of the acute illness and slows down the decline of physical/psychological and social functional abilities
Usually occurs in community hospitals
What is the definition of
- Impairment
- Disability
- Handicap
What are some factors that can contribute to deconditioning in the elderly?
- Polypharmacy
- Acute illness
- Laying in bed
- Unusual environment of hospital
What are some different discharge destinations for elderly patients?
What is a fast track discharge?
Seamless discharge from hospital to patient’s preferred place of care when they have a rapidly deteriorating illness
Should take max of 48 hours
Need to think about anticipatory care needs, anticipatory meds, symptom control, DNACPR
What are the different discharge pathways following a stroke?
- ESDS: - early discharge support service: Intense short term rehabilitation, at home
- Home First: package of care
- CINNS - Community intergrated neurological and stroke service
