6 weeks free NHS intermediate care – what happens next?

Written by Zenya Smith29/05/24

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What is the concept of intermediate care?

Intermediate care services are essentially there to provide additional temporary support following a hospital stay. These services aim to support a faster recovery and help people regain their independence – this may be in their own home, or in a dedicated facility such as a community hospital.  

It can also help people avoid a further admission to hospital during their recovery period, and ease pressure on family carers who may not have the time or necessary skills to take on a caring role. Without the right support network in place, a person may end up staying in hospital a lot longer than they need to be. 

Intermediate care is regularly provided by the NHS. It’s non-means tested – meaning if you’re deemed as needing it it’ll be free for up to 6 weeks. Support can be provided by a team of health professionals including –

  • care home staff 
  • home carers (if you’re recovering at home and are receiving domiciliary care) 
  • occupational therapists – to help you manage everyday tasks more easily 
  • physiotherapists – to help you improve movement and be active 
  • speech and language therapists – to help with any difficulties with communication, eating, and drinking

Your intermediate care team may include all or some of these professionals, depending on what you’re able to do following your discharge from hospital, and what you want to achieve in order to regain your independence. 

Am I receiving intermediate care? 

Intermediate services may have different names depending on the type of support you’re receiving, and the NHS trust that’s delivering it. There are 4 main types that are usually called –

  • reablement – care that helps you relearn how to do daily activities, like cooking, light housework and personal care. This may also be referred to as ‘step-down care’. 
  • crisis response – short-term care up to 48 hours after a hospital discharge 
  • home based care – care delivered in in your own home
  • bed based intermediate care – care delivered away from your home. For example you may be transferred to a community hospital bed – these are small local hospitals that are better equipped to support active rehabilitation than larger hospitals.

NHS intermediate care isn’t always available 

Hospital staff will always assess your health and care needs before you leave hospital to support a safe discharge. However, whether you’re offered up to 6 weeks of free intermediate care can depends on how soon they think you’ll be able to cope at home, and the types of services that are available in your area.

Different NHS trusts offer different intermediate care services. Some may be able to facilitate moving into a residential care home or specialist intermediate care unit, while others may have local support services to help you recover at home.

It’s worth checking on your relevant trust’s website to get an idea of the type of intermediate care you or your loved one may be offered. We’ve included links to patient advice from NHS England below. 

West London 

Central London 

Somerset 

Dorset

Surrey

Sheffield

East Lancashire

Bradford 

Walsall 

Rotherham, Doncaster and South Humber

County Durham and Darlington

If you’ve been discharged without care being put in place, but think you need on-going care it’s best to contact your local social services department as soon as possible. However, if you’re deemed to be able to afford it you’ll have to fund this yourself. The NHS won’t step in and pay for intermediate care once you’ve left hospital. 

In Scotland, you can find out what intermediate care services are available in your area by visiting your local council’s website. If you’re in Wales, you can find out more about intermediate care here. 

Can you refuse NHS intermediate care?

You can, but you shouldn’t need to. During your discharge assessment hospital staff should take into account your wishes and preferences, as well as your health and care needs. 

This means you (and your family if you wish) will be involved in the decisions about what type of support is most suitable and where it’ll take place. If you’d prefer to be cared for at home, but there is limited NHS care options available, the hospital may get your local adult social services involved to offer further support. 

Myself or my loved one has just started intermediate care, what can we expect over the coming weeks? 

Care will usually begin quite quickly – between a few hours or days after leaving hospital. You should receive information about the service, and will work alongside a healthcare professional to plan out your recovery goals, how you’d like to reach them, and identify daily activities that may be difficult. 

You’ll likely have a diary that logs your care and the progress you’re making towards your goals. This information should be written clearly so that you can read and understand it. 

The period of time you receive intermediate services can be subject to change depending on the speed of your progress. If you’re worried or have any questions at any point about your care and recovery, you’ll be provided with the name and contact details of someone to talk to. 

What happens when intermediate care ends?

If you reach the end of the 6 weeks period and need long-term care your care team should provide a plan for transferring to another care service and work with you to agree what happens next. This may involve speaking to social workers from your local council about other types of care, such as home help, daily care visits, or full-time home care. 

You should also be told –

  • how to refer yourself again if you need to
  • what you should do if something goes wrong
  • where to go for other types of support or equipment that might help if you’re still finding some tasks difficult.

If your intermediate care is coming to an end, don’t be afraid to reach out to your contact person about what happens next. It’s good to get ahead so that you can start your needs assessment process and voice your care preferences early. 

Is on-going care also free? 

Unfortunately not. However, you may be eligible for some level of care funding from your local council. 

Now that NHS trusts use the discharge to assess model, There’s no longer a requirement to carry out a care assessment before a person leaves hospital. Carried out by a social worker, this care assessment would usually identify if a person has has eligible care needs for on-going support, and if so, would lead to a financial assessment, to work out if the local council will contribute to or cover the cost of their care. 

Instead, the care needs assessment will be carried out after a period of recovery. You can find out more about the assessment here. 

Arranging long-term care with Elder

If you’re looking for 24/7 care after discharge, Elder can help you connect to local live-in carers who’ll help with difficult daily tasks, while protecting independence and dignity in your own home. 

To get started – 

1) Give us a call – our clinical team may be able to liaise with your intermediate care team or your local social care professionals to check the progress of any care needs assessment, and understand whether the support of a live-in carer would be suitable.

2) If you’re new to the world of care, our care advisors can help you understand more about the different types of funding available. You can also try our free online funding calculator tool to find out whether it’s likely you’re going to be eligible.

3) Create your free online account and submit your care request. This can be done in around 5 minutes and will give us the information we need to shortlist suitable carers. 

4) You’ll receive the profiles of these carers to review – including a short introductory video and feedback from other families they’ve supported. Choose your favourite and chat to them to find out if they’re a good match. You can also complete your care profile in your account too, to give your future carer a complete picture of the type of care you’re looking for. 

5) Once you’ve chosen your carer and agreed a start date you can use your online account to manage your care schedule, keep your care information up to date, and communicate with your carer and the Elder support team. 

Sources –

  • https://beta.bathnes.gov.uk/what-happens-when-your-intermediate-care-ends 
  • https://www.nice.org.uk/about/nice-communities/social-care/quick-guides/understanding-intermediate-care  
  • https://www.ageuk.org.uk/globalassets/age-uk/documents/factsheets/fs76_intermediate_care_and_reablement_fcs.pdf 
  • https://www.nhs.uk/conditions/social-care-and-support-guide/care-after-a-hospital-stay/care-after-illness-or-hospital-discharge-reablement/
  • https://www.nhs.uk/conditions/social-care-and-support-guide/care-services-equipment-and-care-homes/care-and-support-you-can-get-for-free/ 

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