Leaflet 6 - Primary Care and Hospital Discharge

What is Primary Care?
Primary care includes nearly everyone who provides healthcare in the community. Although your first contact may be with a GP, many others are involved in providing care: District Nurses, Physiotherapists, Chiropodists, Mental Health Nurses and Pharmacists, to name a few.

Recognition
Let all of the above know you are a carer. GP's and primary care teams have a duty to identify all carers in their practice to ensure that carers are supported too.

The staff in your GP practice will make a record on your notes that you are a carer. In future, you should be offered advice and support to assist you in your caring role.

What if I don't want any help? - That's fine. But remember, carers needs can change suddenly so knowing where to go for help is important, especially in a crisis.

Help from Primary Care
A primary care team can provide help and advice to you in your caring role

• Information on support for carers
  
• Advice and information on various illnesses and medication
  
• Mobility aids
  
• Dietary advice
  
• Continence advice

If you feel your own health is suffering because of the tasks you do as a carer, help may be available. Carers often suffer from back problems, there may be aids and adaptations you would find useful. Caring can also be stressful - you may find it useful to talk to someone. Relaxation and training may be available from Gateshead Carers Association and Gateshead Crossroads.

Information about medical conditions and local services can often be found in waiting rooms. If you cannot see the information you need, ask at the reception desk. They may hold information that is not on display.

Other sources of information are
NHS Direct 0845 46 47
PALS (Patient Advice Liaison Service) 0800 953 0667
Crossroads Primary Care Worker 0191 478 2423
Gateshead Carers Association 0800 328 9241

Coming out of hospital

When the person you care for comes out of hospital you should both be well informed and prepared for the discharge.

You may not have considered yourself a carer until now and may be trying to adjust to this new situation. On the other hand you may have been managing to care for someone, but now feel unsure that you are able to provide the extra care which will be needed.

If you are worried, speak to the nursing staff at the hospital, the person you care for will have a named nurse. If that person is not available, speak to the nurse in charge or the hospital Social Worker.

It is important for you to speak to someone about any worries that you may have. This may include things such as bathing or changing dressings.

Discharge plans
The named nurse for the person you care for will be responsible for making sure any help needed at home is organised and in place at discharge. The nurse will make a discharge plan and contact any relevant workers who may be needed to provide extra support for the person being discharged. The plan should be discussed with you and the person you are caring for.

If the person you care for requires some help at home they should not be discharged until the services they require have been organised and put in place. This means restarting any services that were in place before admission.

If you will be providing regular care for the person when they come out of hospital, you are entitled to a Carers Assessment. (See Section 2 - Carers' Rights)

If extra help is needed on discharge, the nurse may contact a number of different workers:

Professional Allied to Medicine
Physiotherapists and Occupational Therapists may carry out home assessments and provide education and support to the person being discharged and their carer.

Community Based Services
If the person you are caring for needs social care support they will be referred to a member of a social work team. A named worker will be responsible for arranging any care needed in time for discharge. This could be a member of staff from District, Hospital or Specialist Team.

Discharge Liaison Team
This team is a mix of staff from community health services who can help the ward staff, patient and carer through the discharge process. They can be very helpful if the person you are caring for needs lots of different help when they are discharged.

Community Nursing Team
If the person you care for has a community nurse or will need one after discharge, they should be contacted by the named nurse to ensure they are able to provide any help needed on discharge.

Community Care Nurse Assessors
The Nurse Assessors work with the social work teams to look at patients who need lots of support at home. Some people might not be able to return home because they are unable to manage even with support from a carer, or the carer might no longer be able to provide the support. They will discuss with the patient and the carer what other options are available.

Intermediate Care Services
There are a number of different teams of workers who can provide short term help to the person you care for after being discharged. They also prevent re-admission to hospital by providing support to people who may be having difficulties at home.

Ambulance Service
The ambulance service is responsible for providing transport for patients who are medically unfit to travel by any other means. If you think the person you care for will need an ambulance, let the named nurse know as soon as possible because they need to be booked in advance.

It is important to note that the staff will not be able to request a time for the ambulance to pick up the person being discharged.

It will be helpful to have the names and telephone numbers of the people who will be involved with caring at home, for example the District Nurse or Social Worker. This means you will be able to contact someone if there are any problems with the service. There is space at the front of this pack to write down these contacts.

If you are not happy with any aspect of the arrangements, speak to the nursing staff before discharge begins. You can ask for more help if you think it is needed or more time to prepare for the discharge.

If you are still unhappy after discussing things with the workers involved, you can ask the Primary Care Trust to review the decision. A leaflet on what to do if you are unhappy about discharge arrangements should be available from ward staff.

Gateshead NHS Primary Care Trust
Gateshead PCT is part of the NHS and is the organisation responsible for planning and funding local health services to improve the health of the residents of Gateshead.

The PCT is responsible for providing other health services (hospitals, dentists, patient transport, screening, pharmacies and opticians).

Eventually the PCT will control the majority of the NHS budget so that decisions about local services are made at a local level. The Primary Care Trust is managed by a board, which has a majority of representatives from the local community.

A Professional Executive Committee, made up mainly of GP's, nurses and other clinical staff who work in primary care and community services, supports the board. It is responsible for the health of around 205,000 residents and covers GP practices, dental practices, pharmacies and opticians.

Local people are welcome to attend public board meetings to have a say about local health services. To find out more contact 0191 491 5713.

If you have any queries about any of the information included in this leaflet please contact the Primary Care Worker at Gateshead Crossroads
Tel 0191 478 2423

(See Section 13 - Caring contacts, for full details)