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Our case for change

What happens when I need  rehabilitation support after being ill?

An acute hospital is a place where people go when they are very sick or need urgent care, like after an accident or a serious illness. It has doctors, nurses, and special equipment to treat patients quickly and help them get better. These hospitals often have emergency departments, operating rooms, and wards for people who need to stay for a short time to recover. Once someone has recovered enough that they don’t need this level of hospital care anymore, we know that every day that they stay in the acute hospital slows down their recovery. So we try as hard as possible to make sure that people are able to leave our acute hospitals as soon as possible so they can continue to get better.

Where people go after leaving hospital

Half of the people who leave hospital after being ill are able to go straight home with no further support. There are also a very small amount of people (1%) who are not able to return home again and will need to go to somewhere to receive 24 hour care permanently, often a nursing home or hospice. The other 49% of people are well enough to leave an acute hospital but need further support so they can fully recover. This is known as rehabilitation, which is the help people get to feel better and become stronger after being sick, hurt, or having surgery. It can include exercises, learning how to move again, or doing activities to get back to normal life. 

What kind of extra support is available?

Most people can still go straight home from acute hospitals as long as they have some additional support for a short period of time. In Coventry and Warwickshire, we use a “Community Integrator Model” where one main provider brings together different community support services to create packages of care which can deliver the many different types of support a patient might need to recover. This ensures patients get the right care tailored to their needs and has improved local services, allowing more patients to be cared for at home than before.

Our Community Recovery Service provides short term care for patients who are leaving hospital in their own home and has been supporting people to leave hospital more quickly with most packages starting within two days of referral to the service. In total, 45% of people leaving hospital are able to return home with this kind of support service in place.

The other 4% of people still need full time supervision from clinicians so that they can recover and get better, but do not need the level of intense support an acute hospital provides. These people will go into an interim or temporary bed as part of what is called "Discharge to Assess". Those who need hospital support to get better will go into a community rehabilitation bed, and in South Warwickshire this equates to about 550 people a year.

This consultation is about where these community rehabilitation beds are located to meet the needs of the people who use them.

Key facts about community rehabilitation beds

What does the NHS mean when it talks about beds?

  • When the NHS talks about beds, it doesn’t just mean the physical bed, but the services in place to support the patient who is in the bed. There are many different types of bed which are used in both our acute hospitals and our community hospitals. Some you may have heard of include intensive care beds for people who require critical medical attention and constant monitoring, day beds for people who need a bed for several hours following a procedure or minor operation but will be able to go home that day, or palliative care beds for people who need support at the very end of their life.
  • All of these beds need different types and numbers of staff to ensure the patient in them receives the right level of support to make them better. This consultation is only about one type of bed, which are known as community rehabilitation beds.

What is a community rehabilitation bed?

  • A community rehabilitation bed is mainly used for patients who need extra rehabilitation support before going home after a hospital stay. They can also be used for patients who need more support than they can get at home, but who don’t need to be in hospital. They are not beds that are used in an emergency and they do not offer specialised rehabilitation support, such as the support you need after a stroke or brain injury
  • In South Warwickshire, 90% of people who use our community beds are leaving acute hospitals, but these beds also have a role to play in supporting people to avoid being admitted to acute hospitals. 10% of people who use these beds are admitted from the community, usually referred by a GP or other healthcare provider.
  • Our rehabilitation beds in South Warwickshire are in a community setting. This means that they are not based in hospitals that provide emergency care. Instead, they are in specialist buildings that provide appropriate support.
  • Rehabilitation services include physiotherapy, medicines management, and other services provided by doctors and nurses who look after patients in these beds.
  • Number of beds: In South Warwickshire, there are 35 community rehabilitation hospital beds. We have looked at the data for the past five years and we know that this is enough to provide rehabilitation support to our community. There are also other types of beds located in some community hospitals, but these are not being considered as part of this consultation.
  • Current Bed Distribution: Out of the 35 beds, 19 are at Stratford Hospital and 16 are at Leamington Spa Hospital. The beds at Leamington Spa Hospital were previously located at Ellen Badger Hospital in Shipston. When South Warwickshire University NHS Foundation Trust got funding to redevelop the Ellen Badger Hospital site, these beds were temporarily moved to the Leamington Spa Hospital to allow building works to take place.
  • Minimum ward sizes: When developing our proposals, we had to consider what the minimum number of beds would be on any of the three possible sites so that we could meet clinical requirements, keep patients safe and operate efficiently. Our clinicians have agreed that if we have three separate sites, the only possible arrangement is to have 12 beds at two of the sites, and 11 at the other.