Delivering as a CCG

Geriatric Day Care

Current Provision:

The Nottingham University Hospitals Rehabilitation Unit (NUHRU) aims to provide specialised  comprehensive, multidisciplinary assessment and individualised treatment programmes to meet the goals and needs of frail older out-patients. These are patients whose needs are too complex to be provided for effectively in community such as complex falls patients, early complex stroke patients, Parkinson’s Disease patients and complex geriatric patients. Patients are discussed at a multidisciplinary team (MDT) meeting, and a goal-oriented, individualised care plan produced.

This Service is delivered at the City Campus.

Case for change:

  • Services closer to home such as local GP practices, at home and there is no requirement for patients to visit a hospital day care unit. Patients will have a greater choice of location which should improve patient experience. Currently the location is limited to a single unit.
  • Integrated care with existing primary and community services and secondary care
  • Greater emphasis on patient outcomes and patient experience.
  • Improved links with other community specialist services ie stroke, falls services
  • Value for money i.e activity to this service has been decreasing. Which make this an expensive service to operate in terms of overheads.
  • Reduction on reliance and cost for non-emergency patient transport as patient will now be seen closer to home.

Proposal

CCGs will ensure the re-commissioning of these services to maintain the current principles of crisis management, rehabilitation and self-management through a multidisciplinary approach. Care will be closer to home for patients  – provided in either a community location with specialised equipment or in the home environment.

Referral criteria will remain the same, along with a focus on complex falls and complex neurological conditions including Parkinson’s Disease.

To deliver rehabilitation for this cohort of patients in a new more integrated way. The delivery model will exclude stroke patients where those stroke patients will be cared for by the specialist stroke community service.

Rehabilitation following a multi-disciplinary team approach with physiotherapy, occupational therapy and social care would be provided by a community service. Medical review of complex patients within a multi-disciplinary team environment would also include a community geriatrician service and where complex investigations are needed, these would be requested through secondary care (for example, tilt table testing and imaging).

Close links with primary care on prescribing and medicines management would support the service model and support for nursing services such as continence care and dietetics support would be provided through community services.

Tell us what you think

The engagement period for this service review has now ended.  For an update on the decisions on services, click here.

NUh-services-you-said-we-did-summary

If you would like a paper copy of the You-said-we-did Summary,  please call 0800 028 3693 (option 2)

For further comments, please send your comments to the Patient Experience Team on nnestccg.pet@nhs.net or write to:

Freepost RTHU-JLJL-LGLT

Patient Experience Team

South Nottinghamshire CCGs

Civic Centre

Arnot Hill Park

Arnold

Nottingham

NG5 6LU

If you would like a paper copy of the You-said-we-did summary please call 0800 028 3693 (option 2)

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