Neuro-Rehabilitation is part of the Improving Specialist Care programme because it is a specialist service and regionally it is a service that is increasingly under pressure due to increased demand and complexity of patients. The service, therefore, requires a Greater Manchester solution (rather than local/Trust-based changes) to ensure it is clinically and financially sustainable for the future and has the adequate skilled workforce to deliver high quality care.
Currently, neuro-rehabilitation in-patient services are delivered by the Northern Care Alliance NHS Group (at Salford Royal and Floyd Unit, Rochdale – part of Pennine Acute Trust); Manchester University NHS Foundation Trust (Trafford General) and Stockport NHS Foundation Trust (Devonshire Unit) plus trauma beds commissioned by NHS England.
Across this provision, there are many opportunities to improve services for both patients and the people working within as we know there is:
- Poor access to post-acute Neuro-Rehabilitation services
- Inadequate, inequitable and disjointed patient flow across GM
- Inadequate care and flow for tracheostomy patients, including a relatively heavy reliance on the independent sector to care for these patients
- Variations in care and service provision, including community Neuro-Rehabilitation services
- Staffing levels fall significantly short of national and/or local recommendations
Demand for Neuro-Rehabilitation services has increased and is expected to increase further in the future.
A new model of care seeks to:
- Provide a single point of access for people needing in-patient services
- Improve proactive and integrated discharge with support for patients who can be cared for closer to home
- Reduce time patients spend unnecessarily in hospital
A significant amount of work has been undertaken and clinically-led, including a self-assessment by units and co-design work with patients and staff, to look at a future model of care. It has been determined that a GM-wide single shared service for inpatient Neuro-Rehabilitation is the solution.