New model of care
What are the benefits of a single service?
We believe creating a single service for in-patient services for neuro-rehabilitation across Greater Manchester will lead to a number of improvements for patients and staff working within the service, including:
- Providing a single point of access for people needing in-patient services
- Improving proactive and integrated discharge with support for patients who can be cared for closer to home
- Reducing the time patients spend unnecessarily in hospital
- Improving staffing levels where required to reflect national guidelines
- Moving some work currently provided in the independent sector into the NHS under the single provider
Which organisation’s policies/procedures will the single service adhere to?
No decision has yet been made on this. It is likely that there will need to be an integrated approach to reviewing the policies currently adhered to and what is required in the future model. This will be addressed in advance of the transition process.
How are services going to change?
Hyper-acute and acute inpatient Neuro-rehabilitation will continue to be delivered from the Salford Royal site. In addition, dedicated beds for patients with tracheostomies and prolonged Disorders of Consciousness will also be opened on the Salford site. Post-acute neuro-rehabilitation will continue to be delivered from all three current sites (Trafford, Devonshire Centre and the Floyd Unit), but there will be slow stream neuro-rehabilitation beds also opened within the existing facilities in place of some of the post-acute beds. In addition, staffing levels will be changed to be more in line with BSRM guidelines, which will increase the amount of therapy provided to patients whilst an inpatient.
How will community services be organised?
Each CCG has committed to investing in community neuro-rehabilitation services to bring them up to an acceptable standard and specification. This is a core component of the future service.
You say a new model will help with workforce issues – how?
Inpatient units will receive sufficient funding to increase staffing levels where these currently fall below the BSRM staffing guidelines. This will provide an appropriate workforce to deliver the rehabilitation required by patients within the service. In addition, the single provider will offer benefits in terms of training opportunities, career progression and skill development to staff who wish to access this. .
What is the decision making process/who is making the decisions?
To date, decisions have been made at GM level by the Improving Specialist Care programme. Decisions regarding the new service and implementation will be made by a newly formed Neuro-Rehabilitation Implementation Board which will have representation from all current providers. The group will guide providers through the transition process until the new service structure is embedded within the Single Provider.
Is my job secure?
Yes, no staff member will lose their job as the result of the implementation of the new model of care.
Will staff have to move sites?
There are no current plans to change the sites from which services are delivered.
Will all staff work for Salford Royal?
It is expected that the majority of staff would be employed by Salford Royal in the future model. This will be managed via established HR processes to ensure that all staff are protected accordingly.
Will the team structures change?
There is expected to be an uplift in staffing in-line with the new tariff and to support the model of care. This increase in staffing may change some team structures accordingly.
When will this change take place?
The single service aims to go live in early 2020, following a phased approach to implementation. It is aimed to complete the transition to a single provider by the end of March 2020, with a view to then making the required changes to staffing levels and the function of the units from April 2020 onwards.
Will my terms and conditions change?
Under TUPE all contractual terms and conditions are protected.
What is TUPE?
TUPE refers to the “Transfer of Undertakings (Protection of Employment) Regulations 2006” as amended by the “Collective Redundancies and Transfer of Undertakings (Protection of Employment) (Amendment) Regulations 2014”. The TUPE rules apply to organisations of all sizes and protect employees’ rights when the organisation or service they work for transfers to a new employer.
Will staff be given the option to transfer to their current Trust?
TUPE regulations aim to protect you as employees during a business transfer. Staff identified within the scope of transfer will be subject to the TUPE of service. Further information and consultation relating to TUPE and what it means for you as employees will commence in the near future.
Will my pay date change?
Pay date for all staff employed by Salford Royal is 27th of the month.
What happens to my pension?
If you pay into the NHS Pension Scheme then it will automatically transfer with your employment.
Will my workload change?
In line with the introduction of slow stream neuro-rehabilitation to the NHS provision, it is possible that the nature of the workload and the types of patients being cared for will change to an extent. Also, there are likely to be some changes to processes (for example, use of a different electronic patient record) that will potentially change the way tasks are completed. All staff will be appropriately trained ahead of any such changes.
Where do staff come from if short-staffed?
All staff rotas and allocations would be managed by the divisional nursing leadership team at Salford Royal, or the Salford site coordinators out of hours.
Will we be moved to Salford if we are over staffed or contract?
It is unlikely that there will be a scenario where the centre is over staffed
Will administrative roles be rationalised/changed?
There are not expected to be any changes to the administrative roles currently in place.
How will this affect training for those currently on a course and training in future?
Where possible, current arrangements will continue.
Where will we do our training?
It depends on the specific training – we will aspire to ensure as much as possible can be conducted at local units. However there will be some that will need to be completed at Salford.
Will the IT systems change and will training be provided?
Yes, there is expected to be a change in some IT systems; these are currently being identified and training will be provided.
Will we have consultant/doctors over the weekends?
The current medical model for weekends is likely to remain the same. Telephone advice access to the on-call neuro-rehabilitation consultant and registrar will continue.
Who do we call out of hours for assistance?
Defining the out of hours support model will be a task for the clinical sub group of the implementation programme. The unit will have the support needed out of hours to provide high quality care. Developments will be communicated to all staff regularly
What arrangements will be in place for the provision of support services – clinical and non-clinical?
Many support services such as radiology and pathology are likely to continue as they are now, supported by agreements between the two trusts. Some, such as IT, are likely to transfer to be provided by Salford Royal.
Who should I contact if I have further questions?
In the first instance, please contact your Line Manager.
Do we need to tell our patients anything at this stage?
No, there is no need to tell patients anything. Patients will not experience any disruption to their care; ultimately we are making these changes to improve the care and experience we offer neuro-rehabilitation patients.
Will patients be accessing services on different sites?
There are no current plans to change the sites from which services are delivered.
Questions and Answers from the ‘Ask a Question’ Service
Will nursing staff still be expected to move wards within Trafford General Hospital? At the moment staff on the neuro ward get moved to help cover other wards who are short staffed, will this still happen when Salford come in? Or will it be that our staff stay within our ward and won’t be insured to cover other wards as they will be employed by Salford and not MFT? This is a huge problem on our ward at the moment, we find we are fully staffed and then staff get moved, leaving the ward very short staffed, which then effects not only patient care but has a huge impact on our patients’ therapy?
Thank you for submitting the above question through the ODN website. Staff working on INRU at Trafford General Hospital will be part of the Salford Royal team. You will therefore be dedicated to working on INRU to support patients; we do not foresee any circumstances where this would change.