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March 2013

Re-provision of Neuro-Rehabilitation Services. March 2013. Purpose of the Meeting. Changes to the neuro-rehabilitation service currently provided at The Royal National Hospital for Rheumatic Diseases (RNHRD); Re-provision of neuro-rehabilitation from 1 st April 2013; We need your help

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March 2013

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  1. Re-provision of Neuro-Rehabilitation Services March 2013

  2. Purpose of the Meeting • Changes to the neuro-rehabilitation service currently provided at The Royal National Hospital for Rheumatic Diseases (RNHRD); • Re-provision of neuro-rehabilitation from 1st April 2013; • We need your help Dr Lou Farbus (Head of Public & Patient Engagement for the South of England Specialised Commissioning Group)

  3. Structure of the Meeting • Your opportunity to hear from, and question, our panel of experts; • Our opportunity to hear from you; • Additional information and further opportunities for people to have their say.

  4. Who are the Panel of Experts? • The difference between specialised and non-specialised services; • Who commissions these services now? • Who will commission these services in the future?

  5. Public Engagement Process • Meeting with in-patient service staff • Two public meetings • Online questionnaire • Reports to affected Overview and Scrutiny Committees     

  6. Specialised Neuro-rehab Services • In-patients: approx 40 patients per annum (8-9 beds), of these: • 6-7 level 1 • 1-2 level 2a • Out-patients: approx 30-40 per annum

  7. Where do People come from?

  8. Proposals for Re-provision – Level 1 & Out-patients • Brain Injury Rehabilitation Centre (BIRC), Bristol • Two additional level 1 beds from April , increasing to 5 additional by the end of June 2013 • (24 beds overall. Unit situated on the Frenchay Hospital site) • Oxford Centre for Enablement (OCE) • 2 additional beds from April but could accommodate 3 if required • (33 beds overall, part of Oxford University Hospitals FT) • Both services will offer outpatient services for inpatients following discharge

  9. Proposals for Re-provision Level 2A and Out-patients • Centres in the South West • BIRC – 24 beds overall - increasing as above • Glenside – 2A level service • Plymouth – 15 beds 2A level service – capacity available • Poole – 5 Beds – 2A level service – 2 additional beds possible • Taunton and Somerset – 2A level service – no spare capacity • Swindon BIRT – new 2A level capability service – 20 bed centre (May 2013) • The Dean Neurological Centre, Gloucestershire – currently a level 2A/2B centre

  10. Arrangements for Current Patients • The RNHRD has been managing referrals over the last two months so that patients admitted can be discharged by the end of March. There are currently 4 patients, all of whom are anticipated to be discharged by end of March. • It is estimated that 25 outpatients will need to be transferred to other services. The BIRC and OCE have agreed to see these patients and individual arrangements will be made for each.         

  11. Travel Times The average times/distances are set out in the below table:

  12. Out-patient Neuro-rehab Services • Out-patient care describes medical care or treatment that does not require an overnight stay in a hospital or medical facility. There are several strands to the outpatient service for neuro-rehabilitation: • General medical clinic • Spasticity clinic (Consultant led) • Physiotherapy (including Functional Electrical Stimulation) • Neuropsychology • Counselling • Splinting

  13. Current Patient Activity Current patient activity

  14. How will the needs of B&NES Patients be met after April? • Case note review has been completed to identify future patient needs; • Sirona Care & Health: Bath and North East Somerset’s local health and social care provider of community services; • Already provides a community based neuro-rehabilitation service; • Plan is to extend the Sirona service to cover out-patient services for Bath and North East Somerset’s and Somerset patients; • Discussions with other areas to take place.

  15. How will the needs of Wiltshire Patients be met after April? • Confirm who is currently receiving out-patient support from RNHRD • Confirm who will need on-going intervention after 1st April and what their needs are on an individual patient basis. • GWH already provide a Community Neurology Service (CNT) across Wiltshire. • Plan is to extend CNT service to cover out-patient services for Wiltshire patients

  16. Next Steps for Out-patient Provision • Confirm patient handover arrangements • Communication with patients and their GPs

  17. Our Questions for You…. • What questions do you have about the information we have given so far? • What are the most important things we should bear in mind when commissioning neuro-rehabilitation services for people in the South West? • Is there anything else you would like to ask us?

  18. Next Steps • What will happen to information from today’s meeting? • How to get a copy of the information from today’s meeting; • What can I do if I think of something else I would like to tell commissioners? • How do I claim back my travel expenses? http://www.swscg.org.uk/consultation/ Many thanks for your time and ideas

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