Intermediate care team

The intermediate care team work with patients, families and carers to help them manage illness and avoid being admitted to hospital or becoming dependant on long term care.

Contact details

Address:
St Michael's Primary Care Centre
Gater Drive
Enfield
EN2 0JB

Tel: 020 8702 5680

Fax: 020 8442 7227

The service operates 7 days per week between the hours of 8.30am and 5.00pm.

Community Crisis Response team operate between 5pm and 2am (referrals taken via above tel).

Who we are

The Intermediate Care Service is a partnership of Health and Social Care Enablement staff working together to prevent admissions or re-admissions to hospital and facilitate timely hospital discharge.

What we offer

The Intermediate Care Team will promote independence by working with patients, their families and carers to help them manage more effectively and avoid becoming dependant on long-term care. This includes:

- Rehabilitation following hospital stays

- Support for patients at risk of hospital admission due to exacerbation of existing condition or new acute condition

- Short-term rehabilitation for medically stable patients to enable timely co-ordinated discharge from hospital

- Providing IV antibiotic therapy for patients in their own home for up to 5 days

The team will provide short term nursing and therapy input, in most cases for a period of 1-6 weeks, in the patient's own home environment. The following may be offered based on the assessed need and agreed care plan:

- Nursing

- Physiotherapy

- Occupational therapy

- Rehabilitation assistants

- Support from community mental health nurse

- Support from patient support workers

The frequency of the visits will depend on the outcome of the assessment and agreed with the patient.

Who is the service for

They provide care for patients over the age of 18 years, who are registered with a GP and live in the London Borough of Enfield

Exclusion criteria

- Patients who have had a stroke

- Patients needing cognitive or perceptual retraining

- Non-Enfield residents

- Non-stable medical conditions

How to access the service

- Community health care professions

- Acute services

- GP's including out of hours service

- Social services

- London Ambulance service

Referrals can be made via the SPA (Single point of access)

http://www.beh-mht.nhs.uk/gps-and-referrers/making-referrals---enfield-community-health.htm