If the person you care for has been admitted to hospital, their situation will be assessed by lots of different people, like medical professionals and social care teams.
Discharge from hospital can sometimes mean they go back to their own home, and sometimes discharge might be to a different place, like an ‘assessment ward’ or an ‘assessment bed’ in a hospital or community setting.
If the person you care for is discharged to an assessment bed/ward, their needs continue to be monitored outside the acute environment of a hospital whilst they still receive any treatment they require. One of the most important aspects of staying in an assessment ward is that the right support can be put in place before the person you care for is fully discharged and goes home.
Here we explore certain words and phrases you might come across if someone you care for is admitted to hospital, so you feel more empowered to understand ‘assessment’ as part of the hospital discharge process, and what it might mean for you and the person you care for.
An assessment bed or an assessment ward is an intermediate, temporary placement that provides a place where someone’s needs can be fully assessed, and the right package of care be put in place for them. This supports someone in their recovery, and reduces the risk of them being readmitted to hospital.
Below we look at the different settings in which these assessments can take place.
Depending on their particular situation, someone might be transferred from an emergency or acute setting in a hospital to an assessment ward or an assessment bed. These are specialist areas in the hospital where patients are admitted for short-term observations, usually just for a day or two.
Following an assessment, next steps could include further treatment in the hospital, discharge home with a care plan in place, or transfer to another setting, like an assessment bed in a community hospital or residential care home, for further monitoring and some extra support.
An assessment ward or an assessment bed in a community clinic or a residential care setting offers similar services to those available in a hospital. An assessment bed in the community is for people who do not need acute hospital care but require more than a GP or outpatient setting can provide.
These placements tend to be offered to someone who needs care for more than a couple of days right up to a few weeks. During a stay in an assessment bed in the community, short-term medical treatment might sometimes be given whilst medical and social care assessments are also carried out.
You might hear the terms ‘step-up care’ and ‘step-down’ care if the person you care for has been admitted to hospital and assessments are being made.
‘Step-up care’ is when someone needs more care than they could provide for themselves, but a stay in an acute hospital facility isn’t required. This might mean that social care or health care professionals visit them and provide extra support at home, or they receive bed-based care in a community setting for a while.
‘Step-down care’ is when someone has been discharged from hospital but needs further monitoring, medical care or therapy in a different setting like a community hospital before returning home.
Step-down care may also mean someone goes home but is given some extra help like special equipment or a temporary care package (also called ‘reablement care’) while their progress is closely monitored and a full assessment of their needs is completed over time.
You might also come across the term ‘discharge to assess (D2A) pathway’, which is another way of saying someone is discharged from hospital to another place where a fuller assessment can be made.
It’s also possible in some areas for someone to be discharged to a ‘virtual ward’ or ‘hospital-at-home’, which means they go home to their own bed, but are closely monitored and receive consultant-led hospital care whilst at home. This type of care can last up to 14 days.
If the person you care for is discharged to an NHS assessment ward or assessment bed in a hospital or community setting this stay is always funded for them. If they were to require long term care in a residential setting, then financial assessments would then take place, but you and the person you care for would be informed about this when necessary.
If the person you care for is discharged to an assessment bed, they will receive regular monitoring and support from doctors, nurses, social workers, and other specialist professionals who are there to create the most appropriate personalised ‘care pathway’, in discussion with you both.
A care pathway, as part of a hospital discharge process, is the course of support and treatment thought to best suit someone’s needs following their assessment. It considers someone’s physical, mental and social needs, and a discharge care plan is always drawn up to make sure these needs are addressed.
As a carer, your views and concerns should be a vital part of the discussions that take place before a discharge plan is created, and you should receive a copy of the plan that can be reviewed and updated where necessary. Our article on the importance of identifying yourself as a carer when supporting someone who is in hospital goes into more detail on this here.
If someone you care for has been admitted to hospital, our article on the hospital discharge process and other resources can be found here.
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