1. 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

2. 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…

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

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

12. 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