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BODA GALLON
Chief ExecutiveWhickham Villa LLP
Treasurer /TrusteeTees Valley & Durham Neurological Alliance (TVDNY)
Vice ChairSouth of Tyne Neuro Forum
INTRODUCTIONS
OVERVIEW: OUR CURRENT SERVICES
CHASE PARK REHABILITATION CENTRE
•28 en-suite bedrooms•2 step-through Apartments
MILLFIELD HOUSE CARE HOME
•36 Bedrooms•For Older People and those with Long Term Conditions
WHICKHAM VILLA HEALTH CLUB
•Accessible gym with specialist equipment•Large Hydrotherapy pool with multi-sensory equipment•Café •Holistic therapy suite
SUPPORTING REHABILITATION THROUGH THE ENVIRONMENT
•Improving the existing facilities & aspirations•New facilities: Hydrotherapy pool, Gym Café•Social Context for rehabilitation•Community Hub
HIGH LEVEL OF REFERRALS FOR REHABILITATION CLIENTS
•Consultant in Rehabilitation Medicine•Specialist Community Therapy Team•1:1 Opportunities Team•Specialist Nursing Team
CHASE PARK REHABILITATION CENTRE: DEVELOPING THE SERVICE
DR ANDREW BRADFORD
•Our Consultant in Rehabilitation Medicine •Worked as a Consultant at Walkergate Park, as a G.P. and as a specialist registrar in Neuro Rehabilitation in Liverpool•Interest in complementary and psychological approaches to healthcare
QUALITY AWARDS
•CQC Excellent (3 Star) Rated•2007 Pinders/Caring Business award for Best New Specialist Care development•Headway Approved Provider status
CHASE PARK REHABILITATION CENTRE : THE SERVICE TODAY
CHASE PARK REHABILITATION CENTRE: STEP FORWARD & STEP UP REHABILITATION
STEP FORWARD REHABILITATION
“Chase Park Rehabilitation Centre provides Step Forward and Step Up Rehabilitation.
All input and interventions are focused on planned discharge prior to admission and are focused on clients individual life goals and around enabling the individual to move forward in their lives towards providing as independent a living environment as possible and a sustainable high quality of life”.
STEP FORWARD FEATURES:
•Positive•Flexible•Person Centred •Goal Focused•Emphasis on moving through the service towards the most independent life possible
CHASE PARK REHABILITATION CENTRE: THREE PATHWAYS
THE REHABILITATION THE REHABILITATION
PATHWAYPATHWAYTHE THE IMMEDIATE IMMEDIATE
NEEDS NEEDS PATHWAYPATHWAY
THE DISABILITY THE DISABILITY MANAGEMENT AND MANAGEMENT AND
SLOW STREAM SLOW STREAM REHAB PATHWAYREHAB PATHWAY
PURPOSE OF ADMISSION & DIAGNOSIS
•Snapshot of a changing Client Group•Over 70% Active Rehabilitation Clients
CHASE PARK REHABILITATION CENTRE: CLIENT DEMOGRAPHICS
CHASE PARK REHABILITATION CENTRE: REFERRALS
OCCUPANCY
The average occupancy rate for Chase
Park Rehabilitation Centre is 92%. This
fluctuates throughout the year with a
comparatively high rate of admission
and discharge.
OUTCOMES AND IMPACTS: THE ANNUAL REVIEW
INDIVIDUAL CLIENT OUTCOMES
•Assessment & Review reports•Basket of outcome measures
THE FUTURE
•Expanding the scope•Social Impacts•Collaboration•Neurosciences Network (PROMS)
EVENTS
•Our Events•Others Events•Professional Collaboration
FAMILY SUPPORT AND COMMUNITY GROUPS
•Helping through our resources•Providing support and education
OUTCOMES AND IMPACTS: COLLABORATION
COLLABORATION WITH PROFESSIONALS•Sharing Information•Networking & Changing Culture•Learning Opportunities
APPLES AND ORANGES
How do you compare generic care with a specialist rehabilitation service?
VALUE: THE DIFFERENCE
HEADWAY SAYS:
”There are many care/residential units throughout the North East, how many say that they offer specific services for people with brain
injury?
There are about a dozen, however, are they actually providing specific services or are they generic?
By specific services, we mean appropriate neuro-rehabilitation, and continuing neurological assessments with set goals with the aim of
improving a person’s quality of life, possibly leading to independent living.
Do these care/residential homes involve the local community
therefore addressing social isolation and stigma? Involving the local community can assist residents with regards to a smooth
transition and integration back into the community – Chase Park Rehabilitation Services address these issues, and they focus on the
longer term outcomes”.
Alastair White North East Regional Co-ordinator
Headway – the brain injury association
VALUE: COSTING STRUCTURE
THERAPYTHERAPY
(Physio, OT and SaLT) (Physio, OT and SaLT)
HIGH/MEDIUM/LOWHIGH/MEDIUM/LOW
HOTEL & CAREHOTEL & CARE
(including all (including all Medical & Nursing Medical & Nursing
costs) costs)
HIGH/MEDIUM/LOWHIGH/MEDIUM/LOW
DEDICATED 1:1 DEDICATED 1:1 ENABLEMENTENABLEMENT
(1:1 Opportunities)(1:1 Opportunities)
HIGH/MEDIUM/LOWHIGH/MEDIUM/LOW
• 3 main services• 3 costing bands for each (low, medium and high)• Initial assessment is free of charge in the SHA area• Full flexibility in offering levels of support and costs between these bandings, for
example: -
CASE STUDIES
We can provide a range of case studies to illustrate the impact and return on investment represented by neurological rehabilitation
VALUE: CASE STUDIES – Ever Decreasing Need
0
500
1000
1500
2000
2500
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Month
We
ek
ly c
os
t
case A
Case B
Case C
Case D
Case E
Case F
0
500
1000
1500
2000
2500
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Month
We
ek
ly c
os
t
case A
Case B
Case C
Case D
Case E
Case F
If Mr X were to live to age 70 and the original predictions of his needs were correct, then extrapolating the costs to provide for his needs (without inflation) provided the following figures; •Cost of remaining in Continuing Care placement for rest of Mr X’s life with static level of need from original admission £3,939,000£3,939,000
•Estimated community living care costs for Mr X with 2 carers needed to meet static needs from original admission £8,291,002£8,291,002
•Total rehab and likely care costs once Mr X is resettled in community, assuming continuation of progress to fulfil his potential £1,520,388£1,520,388
Blue line - the cost of his care if he had remained in the facility and not changed, as predicted. Yellow line -The cost of his care had he been moved to live independently in the community with no change in his needs Green line – the actual cost of care plus rehabilitation therapies and return to the community with consequent increase in independence and reduced care needs and costs
VALUE: IN DEPTH CASE STUDY
VALUE: RESIDENTIAL REABLEMENT
SHORT-TERM REABLEMENT PLACEMENTS
Bridging the gap between hospital and home •Medically fit for discharge
•Additional resources required to return home
•Further Reablement/rehabilitation required
•Adaptations or new accommodation required
Short-term packages based on promoting independence and where appropriate offering targeted rehabilitation services to assist an individual to return to living at home.
The Current Situation: CHALLENGES
•Equity of Access•Fragmented Services across North East•Pockets of excellence
•NHS Changes and Drivers•Uncertainty & Loss of Intelligence•Reduce Admissions / Reduce length of Stay / Reduce Re-admissions•Cultural Shift
•Macroeconomics
•Housing•Care Home Trap
•Commissioning•Whole Life Costs
•Community Services•Lack of Priority and Investment
•Personalisation•Customer vs. Consumer
The Current Market: OPPORTUNTITES
•North East Neurosciences Network
•Unique Organisation •Joint Commissioning•Workforce Development•Dataset and Intelligence•Pathways Task Group•Information and Communication (Forums)•Evidenced Based Practice Sub Group•Leadership
•Commissioning
•Clinical Commissioning Groups•Regional Specialised Commissioning
•Blue Sky Thinking
The Way Ahead: Where should we go from here?
•Equity of Access
•Regional Trauma Centre in Middlesbrough•Out of Area Placements Review•Investment in Neuro-rehabilitation•Regional Specialised Commissioning Review
•Collaboration
•Joint Commissioning & Whole Life Cost•Seamless Service Pathway – Whole Systems Approach!•Link Person (Social Work Neuro Specialist / 3rd Sector Advocate)•Neuro Representation on the Local Health and Wellbeing Board
The Current Market: Where should we go from here?
•Personalisation – who drives the market?
•Raising Expectations and Building Communities
•Community Investment
•Self Management•Community Multidisciplinary Rehabilitation•Tele-Care & Assistive Technologies•Vocational and Education support•Housing
•Ensure the ongoing viability of NENP (NENN & NA’s)
Our Future: The Gateway Project - Middlehaven
•Multi Agency Stakeholder Team – (Co-Production)
•The Gateway
•Step Forward Rehabilitation•Step Up Wellbeing Centre & Community/Resource Hub•Transitional Housing & Long Term Housing
•Collaboration
South Tees NHS Trust Middlesbrough Council Middlesbrough PCTHousing (Erimus/Fabrick) Middlesbrough College Teesside UniversityVocational Rehab Social Enterprise TVDNY & 3rd Sector Community Rehab Team Teesside LA’s Telecare and TechnologyONE HCA Tees Valley Unlimited
•Equity of Access for people in Teesside
•Outcomes and Impacts – The ‘Win – Win’
•Regeneration and Investment in Local Services & Local People
Our Future: The Gateway Project - Middlehaven
•Commissioning Event - 2nd November 2011
•Public & Service User Consultation Event - w/c 31st Oct 2011 @ Middlesbrough College
•Planning Submission - December 2011
•Opening Summer 2013