Praleena Prakashan – senior physiotherapist
Growing up in India, Praleena watched lots of health programmes on TV. From then on, all she ever wanted to do was work in healthcare – and become the first person in her family to do so.
This interview is part of a series by South West London ICS, going behind the scenes to get to know the people who keep NHS services working.
Tell us about your job and how you got here
I’m a senior physiotherapist with Sutton Health and Care’s at home team, based at St Helier Hospital. The team acts as a vital bridge between hospital and community services. We play a crucial role in both preventing admissions and facilitating discharges for admitted patients, helping to alleviate pressure on the entire patient flow system.
Every day brings something new, I work across various pathways within the team including the acute medical unit, the emergency department, and I carry out community visits. My role as the lead clinician for discharge to assess involves ensuring patients, who no longer need to be in hospital, receive the necessary support to go home safely. I also oversee the acute medical team and support them in implementing new processes and changes.
I joined this team in 2020 from St George’s, where I worked in inpatient rehabilitation. Prior to that, I also worked at a private neuro-psychiatric hospital and a specialist neuro-disability nursing home. My first job in the NHS was as a physiotherapist in the stroke unit at Kingston Hospital. I was interested in healthcare from a young age and always wanted to make a positive difference in people’s lives.
What’s a typical day like?
I work a 12-hour shift, from 8am to 8pm. At 8am, I go through the acute medical ward handover sheet and patient tracker. I look into the therapy and discharge plan for all our patients. For patients who have been admitted, I complete the handover template and send it to the respective wards. For patients who have been discharged home, I ensure that all onward referrals are completed.
At 9am and 1pm, I attend consultant-led multidisciplinary team meetings in the ward where we discuss patients’ medical needs and their discharge plan. After these meetings, I briefly meet with the therapy team and we allocate patients for review based on priority.
I also review complex patients and support junior staff with patient-related queries and equipment orders. At the end of the day, I ensure that all documentation is updated ready for the next day.
Is there a patient story that highlights why your job helps people?
One patient, admitted after a fall, stands out in my memory. Discharge planning proved complex as he declined all equipment and therapy recommendations. We involved a specialist occupational therapist from social services as he was likely to require specialised equipment.
We assisted this patient to sit daily, which allowed him to build trust with us that eventually led to his acceptance of most recommendations. We arranged a therapy visit at home on discharge day, during which he successfully walked with assistance using his walking aid. This was a great outcome, especially considering the initial recommendation for specialised equipment.
Why is your role important to managing pressure on services?
Our emergency department and acute medical teams play a crucial role in identifying patients who could be safely managed at home with the right support, preventing unnecessary admissions to the ward. Our service also aims to prevent hospital admissions from the community. Our discharge to assess team helps patients who are already on wards, reducing their length of stay.
We achieve this through close collaboration with different teams such as social workers, discharge coordinators, Age UK, virtual ward clinicians and the community reablement ward, which provides rehab opportunities. We also use additional services to support decluttering, deep cleaning and furniture moves, so they happen in a timely manner.
Tell what do you do when you’re not at work?
I’m very religious and I love listening to spiritual talks. I also enjoy cooking Indian dishes. And I have two children who I take to different activities.
What would you be doing now if you hadn’t chosen this career?
I cannot think of myself working in any other field. I have always been keen on working in healthcare, although nobody from my family does. Growing up, I used to love watching health programmes on TV. I wasn’t scared of viewing surgery, but my parents couldn’t watch! I think if I wasn’t a physio, I might have ended up being an occupational therapist or a clinical psychologist.
This article first appeared on the South West London ICS website as part of a series of interviews with people providing care on the winter frontline.