Brain injury, Neuro Assessment and Re-ablement
Please note that following clinical and patient input, the detail in relation to the proposal has been updated to reflect the differences in the complexity in clinical need for a long term neurological condition and a traumatic or acquired brain injury. This change was made on the 6 January 2017. Any comments prior to this date will take this change into consideration.
There are currently three services provided at NUH which serve very similar patient groups:
- Neuro assessment service – this provides outpatient services for patients who have a neurological diagnosis, are under the care of a consultant physician and have specific treatment goals. Specifically the service provides assessment of clinical and psychological needs, identifies and treats or manages problems, and helps co-ordination of services to achieve an integrated, seamless and cost-efficient plan to achieve rehabilitation goals and care.
- Brain injury service – this provides an outpatient service for patients who have had a documented Glasgow Coma Scale Score of 12 or less for at least 30 minutes which requires admission to hospital, and a definite, documented, traumatic brain injury. Specifically it provides interdisciplinary assessment and treatment to patients who present with complex physical and/or cognitive deficits resulting from neurological conditions and who require on-going therapy. Patients are offered an appointment for an initial assessment which results in the their goals/focus for neuro rehabilitation and professionals required being identified
- Neuro re-ablement – this service is designed to rehabilitate and enable patients for a wide range of conditions following their admission to hospital. Specifically it facilitates complex discharges and promote earlier discharges , provides rehabilitation in the patient’s home, and provides specialist neurological rehabilitation for a wide range of conditions
Case for change
The current provision across the three services is very similar. Therefore the proposal is to commission a community based neuro rehabilitation service which is in line with the system values described above.
Proposal for a community neuro-rehabilitation service
We will be looking for a service to be delivered in community clinics and a patient’s own home or permanent place of residence. Specifically the service will:
- Provide a high quality, equitable specialist community neuro-rehabilitation service to reduce the impact of both physical and psychological impairments, maximise independence, reduce mortality and prevent avoidable complications
- Assess patients who are referred and confirm through the multi-disciplinary team whether the patient requires interventions for 16 weeks in relation to a long-term neurological condition or 12 to 14 months for a traumatic or acquired brain injury
- Where clinically appropriate for the service, patients will commence on a 16 week or 12 to 14 month community treatment and rehabilitation programme provided by a multi-disciplinary team
- Ensure that each patient has a senior expert clinician as their case manager who will oversee the delivery of the plan
By bringing together services that are currently delivered separately there is opportunity to review the overall staffing levels and skill mix whilst still ensuring high quality services are delivered.
Patients will receive intensive but time limited rehabilitation after which they will be referred to community services for the continuation of the rehabilitation programme if required
The engagement period for this service review has now ended. For an update on the decisions on services, click here.
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 firstname.lastname@example.org or write to:
Patient Experience Team
South Nottinghamshire CCGs
Arnot Hill Park
If you would like a paper copy of the You-said-we-did summary please call 0800 028 3693 (option 2)