services for patients with abi in remote and rural areas
DESCRIPTION
Dr Barbara Chandler NHS Highland. Services for Patients with ABI in Remote and Rural areas. Context. Scottish ABI NMCN No national standards or targets agreed for management of ABI SIGN guidelines for stroke Sign guidelines for acute TBI QIS neurology agenda Where is ABI? - PowerPoint PPT PresentationTRANSCRIPT
Dr Barbara ChandlerNHS Highland
Scottish ABI NMCNNo national standards or targets
agreed for management of ABISIGN guidelines for strokeSign guidelines for acute TBIQIS neurology agenda
Where is ABI? (Within the National Service Framework for long
term conditions (2005) England and Wales)
BSRM Standards for Rehabilitation Services Mapped on to the National Service Framework for Long-Term Conditions 2009, “inter-disciplinary team”
“Following discharge either from an inpatient rehabilitation unit or from an acute ward, care should be coordinated by a specialist brain injury team, although this resource is not available in all areas.” BSRM/RCP 2010
MAP OF HIGHLAND AND PICTURE OF LOVELY SCENERY
Population of Highland approx 300,000 Northumberland population = 300,000
Prevalence of severe TBI 150/100,000 Prevalence with persisting disabilities
at least 100/100,000
The challenge is that often the “disabilities” are hidden
Started in 1992 and “evolved”To provide a service across the
geographical area of Northumberland for TBI
Community based teamReferrals from
neurosciences; Centre for Rehabilitation GP’s, Social Work, Primary Care team Self referral (always contact GP)
Care Managers 1 Team Lead
Band 8a 2 F/T Band 6 1.5 Level 1
Admin 1 F/T Band 4 1 P/T admin
assistant
1 Neuro-psychol 8a 0.1 Rehab
Medicine 0.1SALT 0.8 OT Band 7 0.6 OT Band 5 0.6 PT Band 7 0.6 PT Band 6 1 Rehabilitation
assistant
Budget £400k staff; £35k non staff costs
Case load 130 +/- 10 Structured discharge plan Re-referrals (TBI a long term condition)
New referrals: 40 / yearMild head injuries – phone call advice
Team has grown and evolved over 18 years
Research into Carer needsResearch into sustained employmentEuropean Educational project –
community rehabilitationExploring employment groups
In each locality
Care Manager based there one day per week
Rehabilitation team members attend for specific patient interventions
Group encouraged to become independent
Headway link / support
Working age adults often with dependent family
Economic argumentNational targets for ABIHighland: ABI pathway – courage to
establish this with existing resourcesFurther resources, but not huge
resources