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Rehabilitation - bedded units (Hertfordshire)

We aim to provide excellent care to help maximise your independence following illness or injury
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Our West Hertfordshire rehabilitation units are for people who have been medically optimised and are ready to leave hospital care. We offer both general and neurological rehabilitation. In some cases, our community beds can be used as part of a rapid care response to avoid people being admitted to hospital

Patients will have therapy input in the rehabilitation units to help them become as independent as possible. Basic nursing care is provided on the units, and we aim to support patients to manage their own health conditions and look after themselves.

We offer rehabilitation to patients over the age of 18 who have recently had a medical episode and require nursing and therapy support following. Our rehabilitation staff assess patients and help them to develop care plans and set rehabilitation goals for their stay, with the goal to be able to be discharged to an appropriate safe discharge destination.

All our rehabilitation units have access to senior doctors from Monday to Friday, who will be available as needed. A consultant makes weekly visits to our rehabilitation units.

Out of hours medical cover is provided by 111.

Clinicians from acute hospitals such as Watford General Hospital, Barnet General, Lister Hospital and many others can refer.

Please contact Discharge to Assess Single Point of Contact (SPOC) team for a referral form. 

Referrer contact details: 

Clear referral criteria are essential to ensure that appropriate support and care is available to all patients in community beds while preventing avoidable admissions.

  • Patients should be registered with a Herts Valleys GP or as a temporary resident
  • Patients should be medically optimised prior to discharge from an acute hospital or GP referrals be medically optimised to safely remain in a community ward.
  • Patients should be assessed as having adequate cognitive ability to engage in rehabilitation for their needs. Dementia is not an exclusion, but patients with diagnoses related to cognitive impairment should have completed a cognitive screen with results recorded on the referral and these patients should be signposted to more appropriate services.

A discharge destination should be identified, which may include ongoing services. This may change based on patients’ changing needs. Additional referral criteria for patients moving into community rehabilitation beds might include:

  • A need for inpatient rehabilitation e.g. where the patient’s home environment is not suitable for community-based rehabilitation 
  • The patient should be ready to engage in rehabilitation
  • The patient should require at most two staff to mobilise
  • The patients should be able and willing to consent to referral. If the referral has been made in their best interests, formal capacity assessment and best interest decision making meeting documentation should be attached to the referral

As an indication of the limitation and to support decision making:

  • The patient should not require supplemental oxygen of more than 2 litres via nasal specs
  • The patient should not require naso-gastric tubes, but patients requiring percutaneous endoscopic gastrostomy (PEG) feeds would be supported
  • The Single Point of Contact and CLCH in-reach teams will assess patients’ needs, e.g. ongoing infections to ensure their needs can be met on the community ward
  • Patients should not be septic
  • Focus to support patients at home where possible.

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