Service lead: Kathy Mason - Modern Matron for Inpatient Care
Tel: 01277 695 108
Email: kathy.mason@nelft.nhs.uk
(Please do not email patient identifiable information to this address) 

Referrals

Referrals to be emailed to mse.msebedbureau@nhs.net

Patient criteria:

• Patients identified as requiring Pathway 2
• Patients whose rehabilitation potential can be most effectively supported in an IMC ward setting.
• Patients who do not require the level of medical or technological intervention of an acute setting.

Inclusion criteria:

• Over 18 years old.
• Medically optimised.
• Those who require inpatient rehabilitation and have demonstrated engagement with a therapy programme.
• Where the IMC rehabilitation pathway is the most appropriate setting for rehabilitation.
• Functional impairment (acute or chronic) where there is potential for improvement. Patients with cognitive impairment need to be able to participate in a rehabilitation programme.
• Partial weightbearing.
• Patients who require low flow oxygen (O₂) via vent mask or nasal cannula, O₂   requirement must not exceed 2 to 3 litres or use of an oxygen concentrator up to 5 litres. Patients need to be transferred with a prescription in place for Oxygen. 
• End of life patients who can be supported within the community IMC bed-based setting on a patient-by-patient basis – admission agreed as patients’ personal choice.
• If a patient is receiving Renal Dialysis this needs to be discussed prior to acceptance.
• Bariatric patients – where the IMC unit can safely meet the patient’s needs.
• Established NIV.
• Spinal Patients need to come across to appropriate unit with an appointment in place for their Orthopaedic follow up and specific management instructions. They also need to have the explicit instructions for use of any collars and spinal braces. 
• PICs and IVs
• PEGs can be supported in the IMC wards but requires planning discussion with the receiving ward.
• Step up patients can be discussed on an individual basis with person allocating beds.

Exclusion criteria: 

• Patients under 18
• Patients whose recovery and rehabilitation can be managed safely and effectively at home.
• Patients whose only requirement is social care or health placement (this can be negotiated on a case-by-case basis based on capacity demands within MSEFT and the receiving Community IMC bed base)
• NEWS score of 4 or more
• Patients who require Non-Invasive Ventilation (unless patient is an established/long term NIV user and is self-caring of the requirement)
• Patients with a tracheostomy
• New transient ischemic attack / Cerebral vascular accident
• Lower limb non weight bearing patients.
• Not medically optimised
• Bariatric patients where the unit cannot safely meet the patient’s needs.
• Patients with acute delirium or requiring 1-1 support due to cognition or behaviours (risk AX to be carried out)
• People who are under Mental Health section (or require services of a MH facility)
• In dwelling surgical drains or PEGs need to be discussed on an individual case by case basis prior to accepting.
• Infectious patients e.g. CDIF, Measles, Covid 19 – admission will be subject to a completed risk assessment and suitability of the IMC community hospital to isolate the patient.
• NG Tubes