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Specialist Therapies -Adults

Specialist Therapies -Adults. Cathy Ingram – Service Manager. Three Pathways. Complex rehabilitation Multidisciplinary, incorporating the falls pathway Neurological rehabilitation Multidisciplinary, incorporating the stroke pathway Musculoskeletal physiotherapy

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Specialist Therapies -Adults

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  1. Specialist Therapies -Adults Cathy Ingram – Service Manager

  2. Three Pathways • Complex rehabilitation Multidisciplinary, incorporating the falls pathway • Neurological rehabilitation Multidisciplinary, incorporating the stroke pathway • Musculoskeletal physiotherapy Single discipline, incorporating new PBC & prison services

  3. Complex and Neuro • Occupational therapy, speech and language and physiotherapy • Approx 40 staff, flexing across pathways • Illness, injury or disability affecting any of the following areas: Personal care; Domestic tasks; Mobility; Leisure education work; Communication; Swallowing

  4. Complex and Neuro • Aims – regaining independence, managing long term/ deteriorating conditions • Assessment, advice, treatment, support, health promotion and education to clients and care givers • Short term, outcome focused interventions • Single or multidisciplinary

  5. Scope of Services • 16 years up Lambeth resident/ GP • Open referral system • Home, intermediate care bed, care home, out patients, gym etc • Individual 121, group and MDT clinics • 2,500-3000 referrals per year • Single point of access with prioritisation criteria

  6. Key Partnerships • Intermediate care– community and bed based • Clinics- specialist older persons, falls, stroke, Parkinson's etc • Specialist teams- elderly physicians, nursing etc • Community matrons • Social services • Integrated care pathways with hospitals, Southwark PCT, LBL etc

  7. Supporting • Care closer to home • Long term conditions • Staying healthy • NSF long term neurological conditions • NSF older people • Stroke strategy • Demand management • NICE /RCP guidelines

  8. Stroke Key Community Elements • Rapid, responsive access to specialist rehabilitation • Early Supported discharge with Economic & qualitative evaluation - ‘in reach’ to hospitals • Psychology • Specialist & integrated reviews post discharge/ acute stroke • Links with long term support/ peer support • User participation in service development

  9. Overview ofthe Falls Journey Discharge Tests e.g Tilt table, Dexa scan, ECG etc FUA for results Discharge Decision making OT Home assessment Referral Falls Clinic Specialist assessment Physio / exercise Intervention: PT led falls Exercise & Education Group 1:1 PTA Otago EP 1:1 Community PT or Out-patient PT Community Exercise Group

  10. The Falls Team 2008 LCCC Whittington

  11. Future Potential C &N • Intermediate care community expansion • Integration with LBL • Integration with ALD therapies • Pathways / ESD for other conditions • Care out of hospital eg critical care in care homes, head and neck specialism • Prison SLT service • Technologies – assistive and therapeutic

  12. Future Potential C & N 2 • Accessibility for hard to reach groups- communication / cognitively impaired- language / homeless /refugee • Capacity building with voluntary and community groups & LBL • Vocational rehabilitation- return to work • Specialist resource within and outside PCT

  13. Musculoskeletal Physio Assess, treat and educate each individual (and as appropriate advise their carers / family) who present with a presumed musculoskeletal dysfunction Return the individual back to his or her optimum functional potential Clients are encouraged to be active participants in the management of their condition and SMART goals are agreed between therapist and patient Single discipline- out patients only, 7 staff, 3000 patients

  14. Examples of Conditions • Osteoarthritis, back pain, knee pain • Soft tissue injuries, sprains and strains • Rehabilitation following orthopaedic surgery e.G. ACL reconstruction/fractures • Sports injuries e.G. Groin pain • Frozen shoulder • Repetitive strain/ work related disorders

  15. Recent Developments • Orthopaedic triage service - PBC • Preferred provider for many GP’s increasing demand by 30% in year • Prison contract • Part of Musculo-skeletal steering group -pathway scoping /planning

  16. Future Potential- MS Physio • Expand to 3 sites • Incorporate GP based physio’s within service • Self referral • Extend telephone advice service • Occupational health physiotherapy • Develop locality alignment, +/- • Single point of triage/ access to Musculo skeletal services

  17. Questions??

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