On the HASU the primary focus of these assessments is to see whether a patient could go straight home from our ward. The therapists will work out whether they can be safe at home, if so what help they would need to keep them safe, and what ongoing therapy needs they may have to continue their recovery at home (e.g. a visiting community therapist).
Patients who are not well enough to go home may need to be transferred to an Acute Stroke Unit (see below) in which case the therapists will produce a detailed report of the patients abilities and disabilities which will be passed on to their new therapy team at the receiving Acute Stroke Unit.
After a day or two about a third of our patients are ready to go home, with the support that they need to carry on getting better if they still have any disability when they leave us. If a patient needs to stay in hospital, they will be transferred to an Acute Stroke Unit near their home. Many of these patients will go to one of the designated Acute Stroke Units in North Central London:
National Hospital in Queen Square (ABIU),
the Royal Free Hospital,
the North Middlesex Hospital or Barnet Hospital,
We ensure that there is a seamless transition of care between the HASU and the Acute Stroke Units at other hospitals.
As soon as the HASU team establishes that a patient will need hospital care for longer than a couple of days, the Repatriation Nurse alerts the Stroke Coordinator on the Acute Stroke Unit that the patient will need transfer to them, and thereafter updates them on a daily basis. This personal contact is extremely important to ensure that we work as a single team, across the whole of North Central London and beyond.
Every patient will be transferred with summaries from the medical, nursing and therapies teams, as well as copies of all of their hospital notes. When the patient arrives at their Acute Stroke Unit, the team there will know every detail of the patient’s care up to that point. The medical summary will concentrate on what the cause of the stroke seems to be, what tests have been done and what the results were, what other investigations need doing and what treatments have been started, what the patient’s nursing needs are, and what the patient can or cannot do.
Specialist rotating staff
The consultants who work on the Acute Stroke Units at the National Hospital (part of our own Trust), Royal Free Hospital, North Middlesex Hospital and Barnet Hospital also work as consultants on the HASU at University College Hospital. We work together to maintain excellent relationships between these organisations.
Therapists also routinely rotate between the HASU and the local Acute Stroke Units (although mainly the Acute Brain Injury Unit as this falls within our own Trust). The nurses have also started to develop similar rotations.