Critical care recovery clinics

Your recovery after critical care

Getting home is a huge step on the road to recovery. While it is often an enormous relief to be back home, some may find the first few weeks a bit of an emotional rollercoaster in terms of readjusting to everyday life.

To help support you during this time, you may be offered an appointment at a Critical Care Recovery Clinic (also called Critical Care Follow-Up Clinic).

What are Critical Care Recovery Clinics?

This appointment will be approximately 8-12 weeks after you have been discharged from hospital and is provided by specialists with an interest in recovery after critical illness. They will also have knowledge of services that may be available to you in the community.

Critical Care recovery clinics are available across most health boards in Wales and may be either face-to-face appointments or held virtually via a website e.g. Attend Anywhere.

During the clinic you will be asked about your recovery, and you will be able to ask the Critical Care staff questions.

Who will be there?

Depending on your location, you may see different professionals but all will ask similar questions and provide advice as needed. You may see any of the following:

a Critical Care consultant
a Critical Care specialist nurse
an Occupational Therapist
a Physiotherapist
a Clinical psychologist
a Dietitian

What to expect?

Before or during your clinic appointment you may be asked to complete a couple of questionnaires regarding your recovery. These are to allow us to gain an understanding of your physical, social and psychological recovery and to ensure that the correct professionals are available in the clinic.

In most health boards, the questionnaires will be

Short-Form 36 (SF-36),
Trauma Screening Questionnaire (TSQ)
Community Post-ICU Presentation Screen (Community PICUPS)
GAD-7
PHQ-9.

During the clinic the team will explore the following:

A critical care debrief:
The doctor or nurse will explain what happened to you during your time in critical care in language which is easy for you to understand. They will answer questions that you have from your time on critical care.
Assessment of physical function:
A thorough assessment to find out what challenges you may still be having and if you are having ongoing problems with pain, loss of strength or function.
Critical care memories (delirium) debrief:
Memories of critical care can often seem very real. These memories can be scary, upsetting or concerning, and patients may not want to talk about this openly for fear of others not understanding. The team will explain how common it is for critically ill patients to suffer delirium. Flashbacks to bad dreams or memories of critical care can occur and talking to the clinical psychologist can be very helpful.
Emotional support:
Recovery from critical illness can be a draining, isolating, challenging and often a lonely process. Patients often find that it is difficult for loved ones to understand exactly what they have gone through, no matter how hard they try. Emotional wellbeing is discussed during the appointment to supplement the electronic questionnaire, which is very helpful to understand if depression, anxiety or post-traumatic stress disorder (PTSD) is affecting your recovery and help with referrals to talking therapy services.

What happens after the clinic?

Depending on what you have discussed and your individual needs, the team will, if required, either signpost you or refer you to other services to help support your recovery.

For example, if you are having ongoing issues with your voice, then you may be referred to the Ear, Nose and Throat (ENT) specialists. Wherever possible the team will update you with any referrals made although providing timescales for this will be very challenging and may not be possible.

In the vast majority, only one attendance at Critical Care recovery clinic will be required. In rare circumstances you may be offered a second appointment. This is normally only if there are outstanding problems to be sorted or a profession e.g. physiotherapy feel you would benefit from one more appointment.

Your GP (and in some cases you) will receive a letter from the team outlining the discussions and any onward referrals. For all future problems or concerns you should see your GP who will be able to access services in your area.