Programme for Health Service Improvement Developing Proposals for Change: Rehabilitation and Re-ablement Workshop January 2008 CARDIFF AND VALE NHS TRUST YMDDIRIEDOLAETH GIG CAERDYDD A’R FRO

The Programme for Health Service Improvement… Established in early 2006 Shared commitment to provide high quality services… Shared recognition that status quo not sustainable… Shared recognition that we are not using existing resources as effectively as we could…. Need to work together to rebalance and refocus services… Need for greater focus on improving health and wellbeing… Need to improve efficiency and effectiveness…

Working together as a health community Key principles A shift of focus from illness and dependence to health and independence Improve quality, safety and outcomes Right care, right time, right place, right professional Focus on services and patient experience Maximise resources to achieve excellence Working together as a health community

Rehabilitation and Re-ablement: what is PHSI trying to achieve? New models of care – earlier intervention to help maintain independence with locality focus Changing demography Equity of access Changing case mix Patient expectation Advances in technology Joint commissioning frameworks with local authorities for long term care

Rehabilitation & Re-ablement: What do the Project Group need to deliver? Agreed service model for rehabilitation and re-ablement services - ensuring capacity is available in the right place and at the right time New or extended services to ensure local and equitable access Recommendations for the future role of each hospital site in relation to rehabilitation Options for re-provision of West Wing and Rookwood prepared for formal consultation in early 2008

Rookwood independent evaluation – January 2006 “The deficiencies of the building are amplified by the long stay nature of many patients, whose privacy and dignity is severely compromised by the nature and quality of facilities. The buildings are well beyond their intended service life and provide some of the poorest facilities that we, as an experienced healthcare practice, have encountered.” Powell Dobson Architects

West Wing independent evaluation – January 2006 “The facility is now grossly substandard, which is detrimental to both the quality and delivery of service to patient and staff morale. The building is not capable of providing the modern facilities or quality of environment necessary to meet the aspirations of consumers in the NHS” Powell Dobson Architects

The Future of Rehabilitation: Framework Document – The now… Current, disparate services are not set up to provide optimal care Current pathways are confusing for patients and professionals Many strengths and weaknesses in current services Recognised and agreed need to re-balance services and resources

The Future of Rehabilitation: Framework Document – The future… Whole system change will be needed to achieve equity and ensure sustainability Shift of focus (and expectation) from hospital to community Prompt and local access to comprehensive MDT assessment Range of options to support and care for patients in their own homes or local community: including admission avoidance and earlier supported discharge

Is this consistent with Policy….? Yes…! Better primary and community based services are essential to help people maintain health and independence Long term care should not be provided in “institutions” whenever possible Hospital care must be safe, high quality and efficient, provided in an environment fit for purpose

Foundation stones for the new pathway… Improved services …. Closer to home….. Better access to hospital services…. Better environments …. Soon….

Objectives for workshop… To agree the clinical pathway for rehabilitation and re-ablement – identifying key interdependencies and stakeholders at each step of the pathway To understand and articulate the capacity required to meet needs in all settings and in each locality To develop recommendations for the future role of each hospital in relation to rehabilitation, re-ablement, respite and long term care