Who we are:
The Discharge Team provide a comprehensive, multidisciplinary and integrated discharge service, supporting all residents of North East Lincolnshire. Regardless of which hospital you are admitted to, if you require social care support, the team may be available to help you either face to face, over the phone or online.
The team is made up of professionals from a range of agencies including Care Plus and Focus and includes Nurses, Social Workers and admission and discharge co-ordinators. Working together with our partners in both secondary and community health and social care, provides holistic assessments and intervention options to those over 18 to meet a person’s identified social care needs.
The aim of our team is to work with people from 72 hours into their hospital journey, through their stay, to the point of discharge and then onward into the community. The team work collaboratively with all hospital trusts, including Northern Lincolnshire and Goole Hospitals (NLAG) at the Grimsby site to ensure a person centred, timely and safe discharge from hospital. We are available to provide information and advice to hospital patients, families and other professionals.
From information and advice about support services to meet your needs, to comprehensive assessment and provision of health or social care support, the team are available to discuss your questions.
The Hospital Discharge Team service includes:
- Information, advice and signposting to community services.
- Comprehensive assessment considering your support needs on discharge
-Case management support for people with existing care.
-Access to intermediate tier and reablement services
-Community Social Care
-Stroke discharge pathway
-Continuing Health Care
-End of life care pathways
What we do:
After 72 hours into your hospital stay and if appropriate, you will be assessed by the team in order to establish what your care and support needs will be on discharge. We will work with carers, family, hospital and community services in order to ensure your support is appropriate to meet your needs.
The team will fully explain the financial implications of all care arrangements recommended for you or requested by you. This will include funding available to you and any rehabilitation services that are appropriate for you.
We will also arrange suitable follow up after discharge to ensure the service that is in place continues to meet your needs and is working well.
The team encourage you to start thinking about your discharge soon after you are admitted into hospital. If you know of any issues that might affect you or your friends and family on discharge from hospital, please contact us or discuss this with the ward staff.
