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It's very difficult as a clinician to know that all your good work sometimes feels like we're setting people up to fail. As an inpatient you can expect the highest standards of care and a commitment to getting people back up and running to the best of their ability.

However we know it can be a different story when patients go home.

There's no consistent approach to rehabilitation within the community and it's not just a postcode lottery of where you live.

It's very disheartening when I see people who have deteriorated since discharge. It's frustrating when the NHS has spent time and money on saving a person's life for example, to see them not getting the support they need when they go home. We often have to take people back into hospital through A&E because they haven't had appropriate care in the community. As clinicians out of their area our hands are tied and increasingly we aren't being asked for our opinions when patients are assessed for example for CHC.

There is a national shortage of staff, we do have a workforce problem and people aren't coming into the specialisms in the numbers that we need. It's the case that we have to do something about it quickly.

Going forward if we're asking patients, their families and carers to be more proactive and self manage we must make sure that what they need from us works alongside that.

At the moment I don't believe it does.

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