Confused about NHS support

On 21 April, a dear friend of mine in his mid 70s had a what the hospital describe as a small bleed on the right side of the brain. He’s now able to swallow puréed food and drink some water but can’t move the left side of his body. His wife has asked my advice as the hospital keep talking about him being ‘medically fit’ and getting ready for discharge.

He and his wife live in Cambridgeshire 200m from the border with Lincolnshire and his GP is located in Lincolnshire. He was taken to Peterborough hospital (Cambridgeshire) as it was closest, but they are saying his further care has to be undertaken by Lincolnshire, however there are no places available in brain injury rehabilitation centres. So two simple questions:

Firstly, can the hospital discharge him to his home even though his wife is unable to look after him and the standard of any physio and other care will be low?

Secondly, can one NHS region refused to provide services to someone who lives in their region, but has a doctor in another region?

Thanks in advance for anyone who can offer advice.

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Morning sorry to hear about your friend. I think the advice your looking for should come from citizens advice. I cannot help you with your questions, maybe someone on our forum can. Or you could ring the stroke association our Stroke Helpline (tel:0303 3033 100) or email [helpline@stroke.org.uk] good luck and I hope you get answers Loraine :blush:

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Hi @iLondoner sorry to hear about your friend.

I would suggest your friend needs a care package in place before he is discharged.

Ask your friend’s wife to speak to the hospital social worker to ask what they are putting in place prior to his discharge, there is usually some kind of interim care plan package the hospital arranges for 6 weeks or so that allows the patient to speak to their local authority to arrange ongoing care along with a financial assessment to see how much one has to contribute.

Check out this link here

Unfortunately I don’t know the answer about your query re the two NHS authorities and which will provide care, but one of them will, it will be detailed in the care plan your friend receives.

Also, tell your friend’s wife to say she cannot look after him whenever discharge is mentioned as, yes, if your friend is medically fit, eg the hospital can do no more for him medically, he can be discharged but only if he will be able to look after himself or has someone to do it, say if his wife agrees to look after him at home. If she needs carers to look after her husband she needs to make this point clear to the hospital discharge staff and not to agree to be his caregiver as the hospital will have discharged their duty of care.

Age UK have some advice on care here your friends may have to pay depending on their financial circumstances and savings.

Wishing you all the very best and I hope your friends get everything sorted out and of course that you friend’s rehabilitation goes well.

Take care, best wishes

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Hi @iLondoner, welcome, so sorry to hear re this. I’ve been discharged twice now in the last year post stroke ‘At Risk’ back Home. I feel for you, as when you’re ill/caring for someone not well …. These Care ‘structures’ should be in place and functional in the NHS. 😵‍💫

On one of the ‘discharges’ (they didn’t even do that properly), I stood my ground assertively (although lying down in the hospital bed lol) … and REFUSED to go home :trophy::partying_face: as I knew I wasn’t being discharged properly and would’ve been at risk’ at Home. Very distressing and exhausting but worth it.

I managed to find out that you can speak to a ‘Site Manager’ whilst you’re still in the Hospital if you’re having any issues! Also the CEO is an option of course. I’d already spoken with the Ward Matron, or should I say she spoke TO me, and won that battle.

Anyway, I managed to get another night at the deluxe hotel :scream: … not … ie zero care and a lot of ‘angry looks’ if anyone did venture near me. I honestly was scared.

By the way, this is just what I did, and it’s just a suggestion…disclaimer :slightly_smiling_face:

The next day was just as bad, and still wasn’t discharged at all, this time … I just rang someone to pick me up in the evening as the staff were treating me horrendously and I was once red I’d have another stroke.

There IS a procedure the Ward should follow, maybe the Stroke Helpline could direct you on that? Age UK?, Silverline? Local MP, Carer’s Association, PALS (based within the Hospital … they should intervene on your behalf whilst you’re in there, and you can also put a complaint thru them re the award, Staff etc). Adult Social Services at your local Council might be another Avenue as in getting an urgent Social Worker. Try to get an Advocate, perhaps ‘SEAP’, to speak on your behalf. The Advocacy People. ‘Rethink’.

Your GP might intervene? There’s also something called a Community Matron. You should be allocated a Stroke Nurse, and be assessed by an OT pre discharge, given meds to last you till sorted with GP before going anywhere. There are also lots of agencies that the Hospital are ‘supposed’ to set you up with to ‘settle you back in at Home, for up to 6 weeks in some cases. Eg ‘Homefirst’? It might depend on which part of the Country you’re in though. If there are speech, swallowing, language issues … then a referral should be made to the ‘SALT’ team (Speech and Language Therapy tea.

NO ONE, in my opinion should be sent home in this way … shocking, again just my opinion.

Overall, if it was me … I’d stand my ground as it were, ring or go physically to the PALS Dept in the Hospital to start with. Don’t be put off. But, I’m not claiming to be an expert … just what I remember from the trauma. So it’s up to you. Btw … my local Hospital has been like this since BEFORE Covid … very often that’s used as an excuse.

Failing all that, slip the word ‘going to the Media/Press’ into a conversation and that might help (I didn’t say that btw ahem!).:roll_eyes:

So sorry to hear of another distress story, and I really do wish you well. Once you start ringing one organisation (stress it’s urgent), you’ll hopefully find they’ll suggest other organisations that might help).

If no one speaks up, then this shocking behaviour will only continue
, but again just do what you can, as you’re under a lot of stress. And be really clear, you feel you can’t help at Home … then someone HAS to step in :pray:

Love to you both, hope all this makes sense, :sparkling_heart::four_leaf_clover:

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Many thanks for the helpful answers. It appears to me that the standards of care vary according to area. Another friend had a stroke of what seemed to be of equal severity, yet when I visited him in Leicester Hospital’s Specialist Neuro-Rehabilitation Unit, he had been there receiving physio and rehabilitation help for 22 weeks with no pressure on discharge.

The friend I’m currently writing about has been in Peterborough Hospital for just 4 weeks. In my opinion he needs rehabilitation and I don’t think the home is the place for him right now.

After my sister-in-law had a stroke we bought a copy of David Guthrie’s ‘Pushing the Boundaries’ which is about his struggle to get his wife adequate rehabilitation care in the UK and how he eventually took her to South Africa for this.

My mother back in the eighties suffered from multiple Tia’s one on the nurses told me to refuse to hand over her keys at which point sheltered housing meals included along with Incas intensive care at home scheme was arranged she loved her new house along with the company with other residents the hospital social worker was furious with the actions in the end my mother lived happily for another 18 months her mood was much higher and of course being Scotland there were no charges

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@iLondoner, I really don’t know. It’s a bit of a post-code lottery at the end of the day, and medical staff are running about doing their thing without a thought for the bigger picture. I thought NHS was national, but Wales and Scotland aside, you are only dealing with England. @Mahoney and @Loshy have provided better advice than what I can offer. My only thing is get on the ringer and call, call, call. Only by speaking to people will things happen, and don’t let them leave you on the hook.

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@Rups morning Rups is all ok? I noticed you’ve been up during the night. Hope you have a nice Monday :blush: best wishes Loraine

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I am okay @Loshy, I generally don’t get to sleep until about 2 or 3 am most nights due to insomnia.