Major Trauma Project Rehabilitation Workstream

1. Major Trauma Project Rehabilitation Workstream Jane Barnacle Beth Cordrey Rehab Workstream Lead Senior Clinical Adviser Major Trauma Project Major Trauma Project

2. Overarching conclusions • Broad spectrum of rehabilitation needs • Rarely common or predictable pathways • Inappropriate and inefficient use of existing services • A more collaborative and flexible approach is required • Consistent service standards and improved data management urgently required

3. Vision for the future • a proactively managed system • consistently high quality care and rehabilitation • most appropriate setting, at the most appropriate time • system works across boundaries • care and rehabilitation provided as close to home as possible, as soon as is clinically appropriate.

4. Proposed strategy for trauma rehab services

5. Project Phases • Current Phase: May – mid August • Future Phase: August onwards

6. Major Trauma Rehabilitation Model Rehabilitation (including optimisation for rehab) Reintegration Stabilisation Principles, policies, procedures, structures Continuing Professional Development MTC IP Rehab Community Services TC Documentation (including prescription for rehabilitation) Navigation Data(using TARN) Governance

7. Project Deliverable 1 Service Specification • Original Designation Criteria was limited on rehabilitation • Opportunity for development • Initial focus on Major Trauma Centres and Trauma Centres

8. Major Trauma Rehabilitation Model Rehabilitation (including optimisation for rehab) Reintegration Stabilisation Principles, policies, procedures, structures Continuing Professional Development MTC IP Rehab Community Services TC Documentation (including prescription for rehabilitation) Navigation Data(using TARN) Governance

9. Project Deliverable 2 Acute Rehabilitation Model • Distinct from the ‘acute phase’ rehabilitation in MTC • Takes principles of formal rehabilitation models • Accessible by all major trauma patients • Demand for London networks not yet known

10. Major Trauma Rehabilitation Model Rehabilitation (including optimisation for rehab) Reintegration Stabilisation Principles, policies, procedures, structures Continuing Professional Development MTC IP Rehab Community Services TC Documentation (including prescription for rehabilitation) Navigation Data(using TARN) Governance

11. Project Deliverable 3 Trauma Rehab Pathway • Mapping the entire pathway from critical care through to community • Encompass existing guidance/ standards i.e.National Service Framework for Long Term Conditions (2005), The NICE Guidance on Critical Care Rehabilitation (2009) and the British Society of Rehabilitation Medicine's Standards for Rehabilitation Services (2009) • Using a model that focuses on key patient milestones, interventions, competencies and systems enablers

12. Major Trauma Rehabilitation Model Rehabilitation (including optimisation for rehab) Reintegration Stabilisation Principles, policies, procedures, structures Continuing Professional Development MTC IP Rehab Community Services TC Documentation (including prescription for rehabilitation) Navigation Data(using TARN) Governance

13. Project Deliverable 4 Data • Performance metrics for rehabilitation • Trauma Audit and Research Network (TARN) • Identifying useful data to assess performance • Links to the pathway being developed

14. Major Trauma Rehabilitation Model Rehabilitation (including optimisation for rehab) Reintegration Stabilisation Principles, policies, procedures, structures Continuing Professional Development MTC IP Rehab Community Services TC Documentation (including prescription for rehabilitation) Navigation Data (using TARN) Governance

15. Project Deliverable 5 Navigation Model • Patient focussed advocate • Facilitation of progression along the pathway: transitions • Optimises patient experience and use of facilities and resources

16. Major Trauma Rehabilitation Model Rehabilitation (including optimisation for rehab) Reintegration Stabilisation Principles, policies, procedures, structures Continuing Professional Development MTC IP Rehab Community Services TC Documentation (including prescription for rehabilitation) Navigation Data (using TARN) Governance

17. Project Deliverable 6 Directory of Services • Directory of Health and Social Care Services to support the London Trauma System • Giving clinicians easy access to up to date and local information about services relevant to this client group • May be outsourced & will need maintaining

18. Major Trauma Rehabilitation Model Rehabilitation (including optimisation for rehab) Reintegration Stabilisation Principles, policies, procedures, structures Continuing Professional Development MTC IP Rehab Community Services TC Documentation (including prescription for rehabilitation) Navigation Data (using TARN) Governance

19. Project Deliverable 7 Documentation • For facilitating pathways and data collection in a more consistent manner • Trauma booklet for London Trauma System • Prescription for Rehabilitation

20. Major Trauma Rehabilitation Model Rehabilitation (including optimisation for rehab) Reintegration Stabilisation Principles, policies, procedures, structures Continuing Professional Development MTC IP Rehab Community Services TC Documentation(including prescription for rehabilitation) Navigation Data (using TARN) Governance

21. Project Deliverable 8 Rehabilitation Clinical Governance Framework • Network level • Tracking patients and reviewing outcomes and quality of rehabilitation provided at each stage of the pathway • Reporting into an overarching performance framework at the London Trauma System

22. Major Trauma Rehabilitation Model Rehabilitation (including optimisation for rehab) Reintegration Stabilisation Principles, policies, procedures, structures Continuing Professional Development MTC IP Rehab Community Services TC Documentation (including prescription for rehabilitation) Navigation Data (using TARN) Governance

23. Project Deliverable 9 &10 Evaluation • Impact and cost-benefit analysis to inform commissioning decisions Future Work • Carrying on the work commenced … • Analysis of demand & capacity (data dependent) • Workforce review and development • Ongoing development of standards • Patient Outcomes - commissioning for outcomes