ADULT HEALTH AND WELLBEING LONG-TERM NEUROLOGICAL CONDITIONS

Size: px
Start display at page:

Download "ADULT HEALTH AND WELLBEING LONG-TERM NEUROLOGICAL CONDITIONS"

Transcription

1 ADULT HEALTH AND WELLBEING LONG-TERM NEUROLOGICAL CONDITIONS i. Summary The National Service Framework for long-term neurological conditions categorises neurological conditions as: Sudden-onset conditions such as traumatic brain injury (TBI) or spinal cord injury Intermittent and unpredictable conditions such as epilepsy, headache, early multiple sclerosis (MS) Progressive conditions such as motor neurone disease, Parkinson s disease (PD), later-stage multiple sclerosis (MS) Stable neurological conditions, which may change due to development or aging, such as post-polio syndrome or cerebral palsy (CP) in adults. Approximately 10 million people across the UK have a neurological condition. The NSF for long-term neurological conditions identifies that: Eight million people in the UK suffer from migraine Neurological conditions account for 20% of acute hospital admissions Neurological conditions are the third most common reason for GP consultations 350,000 people across the UK need help with daily living because of a neurological condition 850,000 people care for someone with a neurological condition. ii. Key Issues and gaps The high levels of deprivation among the population of Salford are associated with a relatively high level of unemployment, a high proportion of people of working age being economically inactive and relatively low levels of educational attainment. Chapter 5: Adult Health and Wellbeing 88

2 iii. Recommendations for commissioning Commission high-quality services for people with neurological conditions Work with the North West Specialist Commissioning Team to commission highquality services for people requiring neurosurgery and spinal surgery Develop a strategy for the management of neurological conditions Raise awareness of neurological conditions amongst GPs to improve care and standardise access to secondary and tertiary care services. Chapter 5: Adult Health and Wellbeing 89

3 1. Who is at risk and why Neurological conditions result from disease of or injury to the nervous system and there are numerous conditions which fall within this category. A study by the Association of British Neurologists in 1993 identified that 75% of referrals to neurologists were for 16 common neurological conditions. However, the other 25% of referrals were for conditions which were less common and often required more time for diagnosis, treatment and long-term support. Examples of less common neurological conditions are brain tumour, Huntington s disease, motor neurone disease, and genetic conditions. (See Appendix 1 Incidence and prevalence of long-term neurological conditions and Appendix 2 Salford expenditure for Antiepileptics, drugs used in Parkinsonism-related disorders and Antimigraine drugs.) 2. Level of need in the population Incidence and prevalence of some neurological conditions in the UK: Incidence and prevalence of long-term neurological conditions UK incidence per 100,000 Estimate for Salford UK prevalence per 100,000 Estimate for Salford CP Epilepsy ,105 Essential tremor 850 1,878 Migraine ,000 33,135 MS PD TBI ,200 2,651 Estimated population for Salford: Mid-2009 projected population(ons) 220,900 Out-patient activity First attendance 2005/6 2006/7 2007/8 2008/9 Neurosurgery actual Neurosurgery expected Neurology actual 1,607 2,423 1,911 2,222 Neurology expected 1,411 1,541 1,673 1,445 Chapter 5: Adult Health and Wellbeing 90

4 Admissions elective 2005/6 2006/7 2007/8 2008/9 Neurosurgery actual Neurosurgery expected Neurology actual Neurology expected Admissions emergency 2005/6 2006/7 2007/8 2008/9 Neurosurgery actual Neurosurgery expected (Source: NHS Compara tors: nww.nhs comparat ors.nhs.u k) Neurology actual Neurology expected For the populatio n of Salford, it would be expected that 37,000 people are living with a neurological condition, 4,500 will have significant disability and 13,200 will require help with activities of daily living (based on estimated figures given in Neuro Numbers Neurological Alliance April 2003). With many neurological conditions, there is no direct link between risk factors and incidence, although lifestyle factors do play a part: for example, high levels of alcohol may lead to an increased incidence of head injury. QOF is available only for people with epilepsy. The QOF data for Q4 2008/9 identified 1,800 people registered with epilepsy in Salford. Although incomplete, QOF data for Q2 2009/10 identified 1,246 people registered with epilepsy in Salford. Both sets of figures would, therefore, indicate a higher than expected prevalence of epilepsy within the population of Salford. Mortality Chapter 5: Adult Health and Wellbeing 91

5 With some neurological conditions, life expectancy is significantly reduced, e.g. the average time from diagnosis to death for a person with motor neurone disease is 14 months. For others, e.g. MS, life expectancy may not be reduced at all. 3. Data and information Data Sources: 2008/09 QOF data for epilepsy NHS Comparators 4. Information from regulators The Department of Health Intensive Support Team has recently met with Salford Royal NHS Foundation Trust (SRFT), the North West Specialist Commissioning Team and the Neurosciences Commissioner from NHS Salford to discuss breaches in the 18-week target for neurosurgery (non-admitted). An action plan has been put in place to address this problem. 5. Current service provision in relation to need People with neurological conditions require a broad range of services: selfmanagement, primary care, secondary care and tertiary care. Intervention may be required from neurology, neurosurgery, neuro-rehabilitation, neuropsychology, neuroradiology and neurophysiology. The NSF for long-term neurological conditions identifies in Quality Requirement 2 the need for early recognition, prompt diagnosis and treatment. Many neurological conditions e.g. headaches, migraine, restless leg syndrome can be diagnosed and managed in primary care. For other conditions, guidelines indicate that diagnosis should be made by a specialist within secondary care services. Some treatment modalities, e.g. disease-modifying therapies used in multiple sclerosis are delivered via tertiary care services. Chapter 5: Adult Health and Wellbeing 92

6 Other pathways into services are unplanned: a patient experiencing a traumatic brain injury will be admitted through the Accident and Emergency Department (A&E) and may require surgery to remove a blood clot. Neurological conditions require different diagnostic tests: for example, assessing the severity of a brain haemorrhage would be achieved using scanning equipment whereas assessing peripheral nerve damage is carried out using nerve conduction tests. Depending on the severity of the problems, patients may require rehabilitation delivered by multi-disciplinary teams; patients with challenging behaviours and people with altered moods may require neuropsychology services. In Salford, patients presenting to their GPs with a variety of neurological conditions may appropriately receive diagnosis and treatment within primary care e.g. patients with headaches where a secondary care appointment is felt to be necessary, patients can choose between a traditional referral to a secondary care consultant or may use the Neurological Integrated Clinical Assessment and Treatment Service (NICATS). With this model the referral is made via Choose & Book for triage where the referral information is reviewed by a neurologist who can opt to: Transfer the patient back to primary care Refer to the Tier 2 Epilepsy or Headache Service Request a scan Transfer patient into secondary care neurology neurosurgery services. If the patient is scanned as the first option, the scan is reviewed by a multi-disciplinary team with the following options: Transfer the patient back to primary care with supporting evidence from the scan results Refer to the Tier 2 Epilepsy or Headache Service Transfer patient into secondary care neurology/neurosurgery services. Patients presenting to A&E with an urgent neurological condition, e.g. sub-arachnoid haemorrhage or TBI, may be admitted and transferred to neurosurgery on-site at Hope Hospital as this is the Greater Manchester Neurosciences Centre. Chapter 5: Adult Health and Wellbeing 93

7 Following surgery, or where a patient has been admitted with an acute neurological condition, the patient may require neuro-rehabilitation to facilitate discharge from hospital. In this case the patient will be transferred to the Acute Neuro-rehabilitation Unit at Hope Hospital until medically stable. If further in-patient rehabilitation is required, the patient is transferred to the Intermediate Neuro-rehabilitation Unit at Trafford General Hospital. On discharge from hospital, and for those patients who are not admitted to hospital but require neuro-rehabilitation, there is the Salford Community Neuro-rehabilitation Team. Referrals can be made to this team by any health or social care professional and by patients and carers for those people who have previously been known to the team and do not require diagnosis. Discharge from hospital is dependent on access to appropriate care packages being established and appropriate placements and housing being available for those people who cannot return to living in their previous accommodation. The Salford Community Neuro-rehabilitation Team is able to provide some support for people to return to work particularly where the patient is re-accessing their previous post. The Brain and Spinal Injury Charity (BASIC) also offers a vocational service, which is particularly useful for patients who are unable to return to their previous work. Many people can be supported to self-manage their neurological conditions but for others the wide variety of problems associated with these conditions makes this difficult to do. 6. Programme budgeting and resources Out-patient cost First attendance 2005 /6 2006/7 2007/8 2008/9 Neurosurgery actual 73,149 88, , ,411 Neurosurgery expected 68,253 75,125 85,880 65,796 Chapter 5: Adult Health and Wellbeing 94

8 Neurology actual 316, , , ,924 Neurology expected 271, , , ,200 Admissions cost elective 2005 /6 2006/7 2007/8 2008/9 Neurosurgery actual 434, , , ,807 Neurosurgery expected 387, , , ,043 Neurology actual 160, , , ,953 Neurology expected 204, , , ,871 Admissions emergency 2005 /6 2006/7 2007/8 2008/9 Neurosurgery actual 641, , , ,419 Neurosurgery expected 320, , , ,693 Neurology actual 161, , , ,264 Neurology expected 178, , , ,982 (Source: NHS Comparators: nww.nhscomparators.nhs.uk) 7. Relevant research and evidence base Department of Health (2005) National Service Framework for Long-term Conditions. London: Department of Health. Available: ents/digitalasset/dh_ pdf (Accessed 17 February 2010) National Collaborating Centre for Chronic Conditions (2006) Parkinson s disease: national clinical guideline for diagnosis and management in primary and secondary care. London: Royal College of Physicians NICE (2003) Multiple Sclerosis - Management of multiple sclerosis in primary and secondary care. NICE, London. Available: (Accessed 17 February 2010) Chapter 5: Adult Health and Wellbeing 95

9 Royal College of Physicians & British Society of Rehabilitation Medicine (2003) Rehabilitation following acquired brain injury: national clinical guidelines (Turner- Stokes L, ed). London: RCP, BSRM. Available: ad647dbdbd38.pdf (Accessed 17 February 2010) Royal College of Physicians, British Society of Rehabilitation Medicine, Multidisciplinary Association of Spinal Cord Injury Professionals, British Association of Spinal Cord Injury Specialists, Spinal Injuries Association (2008) Chronic spinal cord injury: management of patients in acute hospital settings: national guidelines. Concise Guidance to Good Practice series, No 9. London: RCP. Available: (Accessed 17 February 2010) 8. Community engagement Representatives from the Greater Manchester Neurological Alliance sit on the Salford Neurological Conditions Commissioning Group. An invitation for patients/carers to join the group has gone out through the Salford Citizens Panel newsletter. As part of the Greater Manchester review of neuro-rehabilitation services, questionnaires will be sent out to patients who have received in-patient and community neuro-rehabilitation. 9. Unmet needs and service gaps There are difficulties in terms of access to in-patient neuro-rehabilitation, which is currently provided at the Intermediate Neuro-rehabilitation Unit based on Ward 1 at Trafford Healthcare NHS Trust. This is being addressed as part of a Greater Manchester review of neuro-rehabilitation services by the Greater Manchester Neurosciences Network. There is a recognised variation in referral rates for neurology services from Salford GPs, with referrals into the NICATS varying between per 1,000 population. The possible reasons for variation are being evaluated as part of an audit of referral letters by SRFT. In addition, an application has been made for funding through SHINE to enable remedial action to be taken dependent on the results. Chapter 5: Adult Health and Wellbeing 96

10 10. Recommendations for commissioning Commission high-quality services for people with neurological conditions Work with the North West Specialist Team to commission high-quality services for people requiring neurosurgery and spinal surgery Develop a strategy for the management of neurological conditions Raise awareness of neurological conditions amongst GPs to improve care and standardise access to secondary and tertiary care services. 11. Recommendations for further needs assessment A Health Needs Assessment was to be commissioned on behalf of the PCTs across Greater Manchester through CBS. However, the Department of Health is working on a tool to provide information similar to that provided in the North East Network Health Needs Assessment via NHS Comparators. This should be available from April Chapter 5: Adult Health and Wellbeing 97

11 Appendix 1 Incidence and prevalence of long term neurological conditions Estimates for the populaiton of Salford based on national rates Estimated population of Salford Mid-2009 projected population (ONS) 220,900 Condition UK incidence per 100,000 Estimated number in Salford UK prevalence per 100,000 Estimated number in Salford QOF Register Q4 2008/09 QOF Register Q2 2009/10 Cerebral palsy Epilepsy ,105 1,800 1,246 Essential tremor 850 1,878 Migraine ,000 33,135 Multiple sclerosis Parkinson's disease Traumatic brain injury ,200 2,651 Estimates available in Health needs assessment for long term neurological conditions in North East England Downloaded from Appendix 2 Antiepileptics Drugs Used In Park'ism/Related Disorders Antimigraine drugs Quarter Items Actual Cost s 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter 1st Quarter 2009/2010 2nd Quarter 2009/ , ,182 1st Quarter 23, ,443 2nd Quarter 24, ,758 3rd Quarter 23, ,247 4th Quarter 24, ,769 1st Quarter 2009/ , ,868 2nd Quarter 2009/2010 Quarter Items Actual Cost s 5, ,432 1st Quarter 5, ,893 2nd Quarter 5, ,023 3rd Quarter 5, ,537 4th Quarter 4, ,253 1st Quarter 2009/2010 5, ,457 2nd Quarter 2009/2010 Quarter Items Actual Cost s 3,648 62,925 3,688 63,343 3,637 62,810 3,420 55,895 3,523 56,858 3,711 58,429 Chapter 5: Adult Health and Wellbeing 98

12 Information for the data warehouse 2008/09 QOF data for epilepsy, References Association of British Neurologists (1993) Guidelines for the care of patients with common Neurological Disorders in the United Kingdom. Not available online Department of Health (2005) National Service Framework for Long-term Conditions. London: Department of Health. Available: s/digitalasset/dh_ pdf (Accessed 17 February 2010) Neurological Alliance, (2003) Neuro Numbers: A brief review of the numbers of people in the UK with a neurological condition. Available: (Accessed 17 February 2010) Chapter 5: Adult Health and Wellbeing 99

REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD

REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD REHABILITATION MEDICINE by PROFESSOR ANTHONY WARD What is Rehabilitation Medicine? Rehabilitation Medicine (RM) is the medical specialty with rehabilitation as its primary strategy. It provides services

More information

Rehabilitation Medicine Service for Adults with Physical Disabilities

Rehabilitation Medicine Service for Adults with Physical Disabilities Rehabilitation Medicine Service for Adults with Physical Disabilities Information for Professionals Rehabilitation Medicine Service Community & Therapy Services Group This leaflet has been designed to

More information

Measuring quality along care pathways

Measuring quality along care pathways Measuring quality along care pathways Sarah Jonas, Clinical Fellow, The King s Fund Veena Raleigh, Senior Fellow, The King s Fund Catherine Foot, Senior Fellow, The King s Fund James Mountford, Director

More information

Your Huntercombe How do I make a referral?

Your Huntercombe How do I make a referral? Your Huntercombe How do I make a referral? How do I make a referral? You may recently have become unwell, suffered an injury or maybe you know someone who you feel needs further help and advice about their

More information

NEUROLOGICAL REHABILITATION A Briefing Paper for Commissioners of Clinical Neurosciences

NEUROLOGICAL REHABILITATION A Briefing Paper for Commissioners of Clinical Neurosciences NEUROLOGICAL REHABILITATION A Briefing Paper for Commissioners of Clinical Neurosciences British Society of Rehabilitation Medicine C/o Royal College of Physicians, 11 St Andrews Place, London NW1 4LE

More information

Parkinson s Disease: Factsheet

Parkinson s Disease: Factsheet Parkinson s Disease: Factsheet Tower Hamlets Joint Strategic Needs Assessment 2010-2011 Executive Summary Parkinson s disease (PD) is a progressive neuro-degenerative condition that affects a person s

More information

Manifesto for Acquired Brain Injury Rehabilitation

Manifesto for Acquired Brain Injury Rehabilitation Manifesto for Acquired Brain Injury Rehabilitation For further information please contact: Chloë Hayward UKABIF Executive Director PO Box 355 Plymouth PL3 4WD Tel: 01752 601318 Email: ukabif@btconnect.com

More information

IMPROVING YOUR EXPERIENCE

IMPROVING YOUR EXPERIENCE Comments trom the Aberdeen City Joint Futures Brain Injury Group The Aberdeen City Joint Futures Brain Injury Group is made up of representatives from health (acute services, rehabilitation and community),

More information

2014/15 Long Term Conditions: Long-term Neurological Conditions

2014/15 Long Term Conditions: Long-term Neurological Conditions Halton Joint Strategic Needs Long Term Neurological Conditions 2014/15 Assessment 2014/15 Long Term Conditions: Long-term Neurological Conditions 1 P a g e Reader Information Author Contributors Reviewer

More information

The diagnosis of dementia for people living in care homes. Frequently Asked Questions by GPs

The diagnosis of dementia for people living in care homes. Frequently Asked Questions by GPs The diagnosis of dementia for people living in care homes Frequently Asked Questions by GPs A discussion document jointly prepared by Maggie Keeble, GP with special interest in palliative care and older

More information

Neurological Services Plan 2012 2017

Neurological Services Plan 2012 2017 Neurological Services Plan 2012 2017 Our vision... Every person in NHS Ayrshire & Arran referred with a disorder of the nervous system experiences a quality of care that gives confidence to patient, referrer

More information

Information for Adults with Physical Disabilities and Long Term Neurological Conditions

Information for Adults with Physical Disabilities and Long Term Neurological Conditions Information for Adults with Physical Disabilities and Long Term Neurological Conditions Rehabilitation Medicine Service Community & Therapy Services Directorate of Operations This leaflet has been designed

More information

APPENDIX 1 - Salford CCG Operational Plan Delivery Dashboard 2015/16

APPENDIX 1 - Salford CCG Operational Plan Delivery Dashboard 2015/16 APPENDIX 1 - Salford CCG Operational Plan Delivery Dashboard /16 18 tember CCG Outcome Indicator Set -16 Outcomes Measures /16 20015 /16 /16 /16 /16 /16 Securing additional years of life for people with

More information

Neurorehabilitation Strategy Briefing Document and Position Paper

Neurorehabilitation Strategy Briefing Document and Position Paper Neurorehabilitation Strategy Briefing Document and Position Paper Background What is neurorehabilitation? The World Health Organisation defines neurorehabilitation as: A problem-solving process in which

More information

SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY

SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY SECTION B THE SERVICES COMMUNITY STROKE REHABILITATION SPECIFICATION 20XX/YY SECTION B PART 1 - SERVICE SPECIFICATIONS Service specification number Service Commissioner Lead Provider Lead Period Date of

More information

PENN STATE HERSHEY NEUROLOGY. Outpatient Services

PENN STATE HERSHEY NEUROLOGY. Outpatient Services PENN STATE HERSHEY NEUROLOGY Outpatient Services TYPES OF SERVICES PROVIDED All services are multidisciplinary, partnering with other relevant specialties, as needed. Comprehensive stroke and vascular

More information

March 2005. The National Service Framework for Long term Conditions

March 2005. The National Service Framework for Long term Conditions March 2005 The National Service Framework for Long term Conditions March 2005 The National Service Framework for Long term Conditions DH INFORMATION READER BOX Policy HR/Workforce Management Planning Clinical

More information

Joint Future THE GRAMPIAN BRAIN INJURY STRATEGY.

Joint Future THE GRAMPIAN BRAIN INJURY STRATEGY. Joint Future THE GRAMPIAN BRAIN INJURY STRATEGY. 2004-2010 1 Contents. 1. Foreword : Our Vision p.3 2. Executive Summary p.4 3. Some background. p.5 4. Definitions and numbers. p.6 5. Involving users and

More information

Rehabilitation Following Major Trauma in Greater Manchester

Rehabilitation Following Major Trauma in Greater Manchester Rehabilitation Following Major Trauma in Greater Manchester Dr Krystyna Walton Consultant in Neurorehabilitation Director Greater Manchester Major Trauma Rehabilitation Major Trauma Rehabilitation in the

More information

Neurological Rehabilitation in Practice

Neurological Rehabilitation in Practice Neurological Rehabilitation in Practice Christopher Ward Professor & Consultant in Rehabilitation Medicine University of Nottingham School of Community Health Sciences Derby Hospitals Foundation Trust

More information

Adult Neuromuscular pathway (Dec 2014) (18 years onwards)

Adult Neuromuscular pathway (Dec 2014) (18 years onwards) Key DGH Not Specialised Commissioning CCG Funded, Neurosciences Centre activity Specialised Commissioning route funded by NHS England (NHSE) Consultant to Consultant Yorkshire and the Humber Strategic

More information

BSRM Standards for Rehabilitation Services Mapped on to the National Service Framework for Long-Term Conditions

BSRM Standards for Rehabilitation Services Mapped on to the National Service Framework for Long-Term Conditions BSRM Standards for Rehabilitation Services Mapped on to the National Service Framework for Long-Term Conditions British Society of Rehabilitation Medicine C/o Royal College of Physicians, 11 St Andrews

More information

THE ACQUIRED BRAIN INJURY STRATEGY FOR GRAMPIAN.

THE ACQUIRED BRAIN INJURY STRATEGY FOR GRAMPIAN. THE ACQUIRED BRAIN INJURY STRATEGY FOR GRAMPIAN. 2011-2016 * 1 January 2011. Contents 1. Executive Summary 2. Progress and Developments since Grampian BI Strategy 2004-2010 3. Definitions and Epidemiology

More information

End of life care: What problems will we meet in neurological patients? Dr Eli Silber Consultant Neurologist Kings College Hospital

End of life care: What problems will we meet in neurological patients? Dr Eli Silber Consultant Neurologist Kings College Hospital End of life care: What problems will we meet in neurological patients? Dr Eli Silber Consultant Neurologist Kings College Hospital Outline How do neurologists work? Which neurological conditions may require

More information

Response from Neurobehaviour Clinic at National Rehabilitation Hospital to Submission to Second Independent Monitoring Group: A Vision for Change

Response from Neurobehaviour Clinic at National Rehabilitation Hospital to Submission to Second Independent Monitoring Group: A Vision for Change November 30 2009: Page 1 of 5 Response from Neurobehaviour Clinic at National Rehabilitation Hospital to Submission to Second Independent Monitoring Group: A Vision for Change Prepared by: Dr. Simone Carton,

More information

Cardiovascular disease Key contact/author: Dr Veena de Souza, Consultant in Public Health, Buckinghamshire County Council

Cardiovascular disease Key contact/author: Dr Veena de Souza, Consultant in Public Health, Buckinghamshire County Council Cardiovascular disease Key contact/author: Dr Veena de Souza, Consultant in Public Health, Buckinghamshire County Council Introduction Cardiovascular disease (CVD) includes heart disease and stroke. It

More information

Improving emergency surgery. Professor Mike Horrocks September 2014

Improving emergency surgery. Professor Mike Horrocks September 2014 Improving emergency surgery Professor Mike Horrocks September 2014 1 Emergency surgery 1.2m people require emergency surgical assessment or treatment per year Approximately 25% of all surgical admissions

More information

National Clinical Programmes

National Clinical Programmes National Clinical Programmes Section 3 Background information on the National Clinical Programmes Mission, Vision and Objectives July 2011 V0. 6_ 4 th July, 2011 1 National Clinical Programmes: Mission

More information

Early Supported Discharge (in the context of Stroke Rehabilitation in the Community)

Early Supported Discharge (in the context of Stroke Rehabilitation in the Community) Early Supported Discharge (in the context of Stroke Rehabilitation in the Community) Gold Standard Framework This document was produced with reference to national standards for best practice (e.g. NICE

More information

2. The aims of this enhanced service in 2013/14 are to encourage GP practices to:

2. The aims of this enhanced service in 2013/14 are to encourage GP practices to: ENHANCED SERVICE SPECIFICATION RISK PROFILING AND CARE MANAGEMENT SCHEME Introduction 1. This enhanced service has been designed by the NHS Commissioning Board (NHS CB) to reward GP practices 1 for the

More information

Specialised Spinal Cord Injury Services and QIPP

Specialised Spinal Cord Injury Services and QIPP Specialised Spinal Cord Injury Services and QIPP Contents 1. Executive Summary 2. Background 2.1 What is QIPP? 2.2 Specialised Spinal Cord Injury Services the current picture 2.3 Specialised Spinal Cord

More information

Main Specialty/Treatment Function Codes. Human Behavioural Guidance

Main Specialty/Treatment Function Codes. Human Behavioural Guidance Human Behavioural Guidance Version No: 0.1 Purpose of this document This document comprises the Human Behavioural Guidance for NHS Organisations in relation to the changes to the Main Specialty and Treatment

More information

Everyone counts Ambitions for GCCG for 7 key outcome measures

Everyone counts Ambitions for GCCG for 7 key outcome measures Everyone counts s for GCCG for 7 key outcome measures Outcome ambition Outcome framework measure Baseline 2014/15 Potential years of life lost to 1. Securing additional years of conditions amenable to

More information

Services for People with Chronic Neurological Conditions

Services for People with Chronic Neurological Conditions Services for People with Chronic Neurological Conditions Pathway Report Report Date: October 2013 Visit Dates: October 2012 March 2013 Images courtesy of NHS Photo Library INDEX Introduction... 3 Findings...

More information

Victorian Nurse Practitioner Project Phase 4, Round 4.11 - Chronic Disease Management

Victorian Nurse Practitioner Project Phase 4, Round 4.11 - Chronic Disease Management Victorian Nurse Practitioner Project Phase 4, Round 4.11 - Chronic Disease Management Eastern Health Multiple Sclerosis Nurse Practitioner Service Model April 2014 Prepared by Jodi Haartsen and Deanna

More information

SCR Expert Advisory Committee

SCR Expert Advisory Committee SCR Expert Advisory Committee Terms of Reference Judith Brodie, Chair August 2015 1 Copyright 2015, Health and Social Care Information Centre. Contents Contents 2 1. Background and Strategic Justification

More information

Rehabilitation medicine

Rehabilitation medicine 2 Specialties Rehabilitation medicine Rehabilitation medicine Dr John P McCann MD FRCP FRCPI Consultant in rehabilitation medicine Dr Christopher W Roy MBChB FRCP(Glasg) Retired consultant rehabilitation

More information

Service Specification Template Department of Health, updated June 2015

Service Specification Template Department of Health, updated June 2015 Service Specification Template Department of Health, updated June 2015 Service Specification No. : 2 Service: Commissioner Lead: Provider Lead: Period: Anti-coagulation monitoring Date of Review: 31 st

More information

D04/ODN/a NHS STANDARD CONTRACT FOR NEUROMUSCULAR OPERATIONAL DELIVERY NETWORKS SCHEDULE 2- THE SERVICES A. SERVICE SPECIFICATIONS

D04/ODN/a NHS STANDARD CONTRACT FOR NEUROMUSCULAR OPERATIONAL DELIVERY NETWORKS SCHEDULE 2- THE SERVICES A. SERVICE SPECIFICATIONS D04/ODN/a NHS STANDARD CONTRACT FOR NEUROMUSCULAR OPERATIONAL DELIVERY NETWORKS SCHEDULE 2- THE SERVICES A. SERVICE SPECIFICATIONS Service Specification No. Service Commissioner Lead Provider Lead Period

More information

EUROPEAN BOARD OF PHYSICAL AND REHABILITATION MEDICINE LOGBOOK EUROPEAN UNION OF MEDICAL SPECIALISTS UEMS

EUROPEAN BOARD OF PHYSICAL AND REHABILITATION MEDICINE LOGBOOK EUROPEAN UNION OF MEDICAL SPECIALISTS UEMS EUROPEAN BOARD OF PHYSICAL AND REHABILITATION MEDICINE LOGBOOK EUROPEAN UNION OF MEDICAL SPECIALISTS UEMS IDENTIFICATION... 2 INSTRUCTIONS FOR USE... 3 THE TRAINING COURSE... 3 TRAINING PROGRAMME... 4

More information

Commissioning Support for London. Stroke rehabilitation guide: supporting London commissioners to commission quality services in 2010/11

Commissioning Support for London. Stroke rehabilitation guide: supporting London commissioners to commission quality services in 2010/11 Commissioning Support for London Stroke rehabilitation guide: supporting London commissioners to commission quality services in 2010/11 Contents Executive summary 4 1 Introduction 7 1.1 Healthcare for

More information

Big Chat 4. Strategy into action. NHS Southport and Formby CCG

Big Chat 4. Strategy into action. NHS Southport and Formby CCG Big Chat 4 Strategy into action NHS Southport and Formby CCG Royal Clifton Hotel, Southport, 19 November 2014 Contents What is the Big Chat? 3 About Big Chat 4 4 How the event worked 4 Presentations 5

More information

Re: Provision of Neuro-Rehabilitation at the Royal National Hospital for Rheumatic Diseases OSC Briefing: For Information & Comment

Re: Provision of Neuro-Rehabilitation at the Royal National Hospital for Rheumatic Diseases OSC Briefing: For Information & Comment Bath and North East Somerset (B&NES) Health and Social Services Overview & Scrutiny Panel Briefing FOR INFORMATION Potential Re-provision of RNHRD Neuro-Rehabilitation Service PART 1 Re: Provision of Neuro-Rehabilitation

More information

Specialist brain injury services. Rehabilitation Transitional medical care Community support Special education

Specialist brain injury services. Rehabilitation Transitional medical care Community support Special education Specialist brain injury services Rehabilitation Transitional medical care Community support Special education I don t know where we d be without the support we ve had from the staff at The Children s Trust.

More information

SAM KARAS ACUTE REHABILITATION CENTER

SAM KARAS ACUTE REHABILITATION CENTER SAM KARAS ACUTE REHABILITATION CENTER 1 MEDICAL CARE Sam Karas Acute Rehabilitation The Sam Karas Acute Rehabilitation Center is a comprehensive and interdisciplinary inpatient unit. Medical care is directed

More information

Improving General Practice a call to action Evidence pack. NHS England Analytical Service August 2013/14

Improving General Practice a call to action Evidence pack. NHS England Analytical Service August 2013/14 1 Improving General Practice a call to action Evidence pack NHS England Analytical Service August 2013/14 Introduction to this pack This evidence pack has been produced to support the call to action to

More information

2014/15 National Tariff Payment System. Annex 7A: Specified services for acute services for local pricing

2014/15 National Tariff Payment System. Annex 7A: Specified services for acute services for local pricing 2014/15 National Tariff Payment System Annex 7A: Specified services for acute services for local pricing 17 December 2013 Publications Gateway Reference 00883 Annex 7A: Specified services for acute services

More information

Key Health Areas Mapped to Out of Hospital Programme Areas

Key Health Areas Mapped to Out of Hospital Programme Areas 1 Key Area (according to letter from David Nicholson) Reducing the number of years of life lost by the people of England from treatable conditions (e.g. including cancer, stroke, heart disease, respiratory

More information

Southwark Clinical Commissioning Group Lambeth Clinical Commissioning Group

Southwark Clinical Commissioning Group Lambeth Clinical Commissioning Group Getting the Vision Right: A multi-disciplinary approach to providing integrated care for respiratory patients Dr Noel Baxter, GP NHS Southwark CCG Dr Irem Patel, Integrated Consultant Respiratory Physician

More information

Rehabilitation services for long term neurological conditions: what works and what is available?

Rehabilitation services for long term neurological conditions: what works and what is available? EVALUATING MODELS OF SERVICE DELIVERY AUGUST 2008 ResearchSummary Rehabilitation services for long term neurological conditions: what works and what is available? Over a million people are treated for

More information

GP workshop. Maria Fitzpatrick Nurse Consultant Kings College Stroke Centre

GP workshop. Maria Fitzpatrick Nurse Consultant Kings College Stroke Centre GP workshop Maria Fitzpatrick Nurse Consultant Kings College Stroke Centre Stroke: the Facts Stroke: the Facts Every 5 minutes someone in the UK has a stroke 1 in 4 men and 1 in 5 women will have a stroke

More information

Breaking Down the Barriers - Masterclass training package and modules

Breaking Down the Barriers - Masterclass training package and modules Breaking Down the Barriers - Masterclass training package and modules Assessment of a patient with urgent mental health needs in an emergency department Module 1 Module 2 Mental health awareness training

More information

PHYSICAL ACTIVITY REVIEW

PHYSICAL ACTIVITY REVIEW PHYSICAL ACTIVITY REVIEW Care Pathway/Service Commissioner Lead Provider Lead Board Approval & Comments Clinically Advised Physical Activity/ Rehabilitation Programmes. Helen Bailey, Locality Commissioning

More information

An Audit and Review of Neurological Services across Gloucestershire 2012

An Audit and Review of Neurological Services across Gloucestershire 2012 An Audit and Review of Neurological Services across Gloucestershire 2012 A report commissioned by, and for the use of Contents Page 1. Introduction 3 2. Key Findings 7 3. Phase two in-depth analysis 16

More information

Job Description MEDICAL SERVICES. 2. To provide appropriate and timely advice and assistance to the Acute Care Services.

Job Description MEDICAL SERVICES. 2. To provide appropriate and timely advice and assistance to the Acute Care Services. Job Description POSITION: PHYSICIAN RESPONSIBLE TO: CLINICAL DIRECTOR, MEDICAL SERVICES PRINCIPAL OBJECTIVES: 1. To provide medical services to the community served by the South Canterbury District Health

More information

SENATE, No. 368 STATE OF NEW JERSEY. Introduced Pending Technical Review by Legislative Counsel PRE-FILED FOR INTRODUCTION IN THE 1996 SESSION

SENATE, No. 368 STATE OF NEW JERSEY. Introduced Pending Technical Review by Legislative Counsel PRE-FILED FOR INTRODUCTION IN THE 1996 SESSION SENATE, No. STATE OF NEW JERSEY Introduced Pending Technical Review by Legislative Counsel PRE-FILED FOR INTRODUCTION IN THE SESSION By Senators MATHEUSSEN and LYNCH 0 0 AN ACT concerning subacute care

More information

OhioHealth Neuroscience

OhioHealth Neuroscience SEPTEMBER/OCTOBER 2013 OhioHealth Neuroscience CLINICAL UPDATE IN THIS ISSUE: NEW SERVICES OhioHealth advancing many of its programs across the neuroscience continuum of care NEW FACILITY OhioHealth Rehabilitaton

More information

Review of Stroke Services in Tameside. Personal and Health Services Scrutiny Panel

Review of Stroke Services in Tameside. Personal and Health Services Scrutiny Panel Review of Stroke Services in Tameside Personal and Health Services Scrutiny Panel July 2012 Contents Paragraph Page No. Introduction by the Chair Summary 1 2 2 4 Membership of the Scrutiny Panel 3 4 Terms

More information

Dementia and Mild Cognitive Impairment

Dementia and Mild Cognitive Impairment Standard 5.1 Dementia and Mild Cognitive Impairment Aims To reduce the gap between expected and actual dementia prevalence and the variance between practices. To improve the assessment of all patients

More information

Wandsworth Respiratory Clinical Reference Group Annual Progress Report 2014/15

Wandsworth Respiratory Clinical Reference Group Annual Progress Report 2014/15 Wandsworth Respiratory Clinical Reference Group Annual Progress Report 2014/15 April 2015 Dr Kieron Earney & Kate Symons Acknowledgements Dr Sarah Deedat Public Health Lead for Long Term Conditions 1 1.

More information

BupaCare. Policy summary

BupaCare. Policy summary BupaCare Policy summary Effective from 1 January 2016 This policy summary contains key information about BupaCare. You should read this carefully and keep it in a safe place afterwards. Please note that

More information

Time to Act Urgent Care and A&E: the patient perspective

Time to Act Urgent Care and A&E: the patient perspective Time to Act Urgent Care and A&E: the patient perspective May 2015 Executive Summary The NHS aims to put patients at the centre of everything that it does. Indeed, the NHS Constitution provides rights to

More information

Leicestershire Joint Strategic Needs Assessment

Leicestershire Joint Strategic Needs Assessment Leicestershire Joint Strategic Needs Assessment YOUNG DISABLED ADULTS - PHYSICAL DISABILITY September 2009 1 TABLE OF CONTENTS 1.1 INTRODUCTION 4 1.2 DEMOGRAPHY 6 1.3 CHAPTER LINKS 16 1.4 FACTORS RELATED

More information

Doncaster Community Health Team for Learning Disabilities. Information for families and carers. RDaSH. Learning Disability Services

Doncaster Community Health Team for Learning Disabilities. Information for families and carers. RDaSH. Learning Disability Services Doncaster Community Health Team for Learning Disabilities. Information for families and carers RDaSH Learning Disability Services Useful contact numbers General enquiries: 01302 796467 Duty nurse number:

More information

QIPP Right Care. NHS Milton Keynes Health investment slide pack. July 2010

QIPP Right Care. NHS Milton Keynes Health investment slide pack. July 2010 NHS Milton Keynes Health investment slide pack July 2010 About this health investment pack Purpose / Objectives to highlight the scale of variation in healthcare at PCT and GP Practice level and demonstrate

More information

RESPIRATORY CLINICAL REFERENCE GROUP (RCRG) PROGRESS REPORT

RESPIRATORY CLINICAL REFERENCE GROUP (RCRG) PROGRESS REPORT RESPIRATORY CLINICAL REFERENCE GROUP (RCRG) PROGRESS REPORT 1. Executive Summary The Purpose of this report is to provide the Wandsworth Clinical Commission Group Board with an update on the progress on

More information

Children s Neuro Update

Children s Neuro Update April 2012 Children s Neuro Update Welcome... From Anne Moore Chair of Safe and Sustainable s Paediatric Neurosurgery Steering Group, and President of the Society of British Neurological Surgeons Welcome

More information

Care Closer to Home. The Gateway, Middlesbrough: A New Integrated Health, Social Care & Housing Pathway

Care Closer to Home. The Gateway, Middlesbrough: A New Integrated Health, Social Care & Housing Pathway Case Study 111 Care Closer to Home. The Gateway, Middlesbrough: A New Integrated Health, Social Care & Housing Pathway This case study sets out the economic, health and social benefits of Keiro s service

More information

Evidence on the quality of medical note keeping: Guidance for use at appraisal and revalidation

Evidence on the quality of medical note keeping: Guidance for use at appraisal and revalidation Health Informatics Unit Evidence on the quality of medical note keeping: Guidance for use at appraisal and revalidation April 2011 Funded by: Acknowledgements This project was funded by the Academy of

More information

The Acute Neurological Rehabilitation Unit

The Acute Neurological Rehabilitation Unit The Acute Neurological Rehabilitation Unit Welcome The Wellington Hospital s Acute Neurological Rehabilitation Unit is the largest private unit in the UK, with 60 rooms specifically designed for neurological

More information

Rehabilitation Medicine Programme

Rehabilitation Medicine Programme Update Report HiPE data from 2010 shows that approximately 30,000 individuals discharged from hospital presented with a neurological condition and/or amputation. Of these, it is likely that 50% should

More information

Evaluation of Community Rehabilitation Service Delivery in Long-Term Neurological Conditions Diana Jackson Senior Research Fellow

Evaluation of Community Rehabilitation Service Delivery in Long-Term Neurological Conditions Diana Jackson Senior Research Fellow Evaluation of Community Rehabilitation Service Delivery in Long-Term Neurological Conditions Diana Jackson Senior Research Fellow Department of Palliative Care, Policy & Rehabilitation King s College London

More information

OT service design for new emergency care - how we can support integrated practice

OT service design for new emergency care - how we can support integrated practice OT service design for new emergency care - how we can support integrated practice Barbara Kemp Clinical Lead for Occupational Therapy Northumbria Healthcare Foundation Trust #theotshow #theotshowselfie

More information

Connection with other policy areas and (How does it fit/support wider early years work and partnerships)

Connection with other policy areas and (How does it fit/support wider early years work and partnerships) Illness such as gastroenteritis and upper respiratory tract infections, along with injuries caused by accidents in the home, are the leading causes of attendances at Accident & Emergency and hospitalisation

More information

The Regulation and Quality Improvement Authority. Review of Brain Injury Services in Northern Ireland

The Regulation and Quality Improvement Authority. Review of Brain Injury Services in Northern Ireland The Regulation and Quality Improvement Authority Review of Brain Injury Services in Northern Ireland September 2015 Assurance, Challenge and Improvement in Health and Social Care www.rqia.org.uk The Regulation

More information

Reorganized and administrated a home health neuro intervention program.

Reorganized and administrated a home health neuro intervention program. HENRY P. BRENNAN, JR., MS, SLP, CCM, CLCP, NCG 2205 Enterprise Drive, Suite 511 Westchester, Illinois 60154 (708) 338-4530 [Office] (708) 338-4531 [FAX] buddy.brennan@rehabassist.com EDUCATION: 2003 University

More information

National Diabetes Treatment and Care Programme

National Diabetes Treatment and Care Programme National Diabetes Treatment and Care Programme Introduction to and supporting documentation for VALUE BASED TRANSFORMATION FUNDING SITE SELECTION December 2016 1 Introduction and Contents The Planning

More information

4. Does your PCT provide structured education programmes for people with type 2 diabetes?

4. Does your PCT provide structured education programmes for people with type 2 diabetes? PCT Prescribing Report Drugs used in Type 2 Diabetes Discussion Points 1. Does your PCT have a strategy for prevention of type 2 diabetes? Does your PCT provide the sort of intensive multifactorial lifestyle

More information

HSCIC Statistical Publications

HSCIC Statistical Publications Author Julie Stroud Date 31 March 2015 1 Copyright 2015, Health and Social Care Information Centre. Contents Contents 2 Purpose 3 Background to HSCIC Official Statistics 3 Forthcoming Publications 3 Official

More information

BUPACARE POLICY SUMMARY. Effective from 1 January 2015. bupa.co.uk

BUPACARE POLICY SUMMARY. Effective from 1 January 2015. bupa.co.uk BUPACARE POLICY SUMMARY Effective from 1 January 2015 bupa.co.uk 2 This policy summary contains key information about BupaCare. You should read this carefully and keep it in a safe place afterwards. Please

More information

Reconfiguration of Surgical, Accident and Emergency and Trauma Services in the UK

Reconfiguration of Surgical, Accident and Emergency and Trauma Services in the UK Reconfiguration of Surgical, Accident and Emergency and Trauma Services in the UK K Reconfiguration of Surgical, Accident and Emergency and Trauma Services in the UK Summary Our aim is to provide an excellent

More information

Intermediate Care Homes. Camden Clinical Commissioning Group. Care Home LCS Spec v1

Intermediate Care Homes. Camden Clinical Commissioning Group. Care Home LCS Spec v1 Locally Commissioned Service Clinical Lead Commissioner Reporting Mechanism/Frequency Payment Frequency Payment Contact This Version GP Cover of Nursing, Residential, Extra Care and Intermediate Care Homes

More information

Recommendations for improving Neurological Care

Recommendations for improving Neurological Care Recommendations for improving Neurological Care Further information and guidance in support of: Strategic Commissioning Guidance to support commissioning plans 2016-17 - Neurological Care South East Strategic

More information

Early Response Concussion Recovery

Early Response Concussion Recovery Early Response Concussion Recovery KRISTA MAILEY, BSW RSW, CONCUSSION RECOVERY CONSULTANT CAREY MINTZ, PH.D., C. PSYCH., PRACTICE IN CLINICAL NEUROPSYCHOLOGY FOR REFERRAL: Contact Krista Mailey at (204)

More information

NHS outcomes framework and CCG outcomes indicators: Data availability table

NHS outcomes framework and CCG outcomes indicators: Data availability table NHS outcomes framework and CCG outcomes indicators: Data availability table December 2012 NHS OF objectives Preventing people from dying prematurely DOMAIN 1: preventing people from dying prematurely Potential

More information

Commissioning better headache services!

Commissioning better headache services! Commissioning better headache services! DE Bateman NCD Neurology 21/10/15 www.england.nhs.uk The financial burden of headache! Direct cost to the NHS: 1 billion per year (Ridsdale 2007) GP consults and

More information

Presenting evidence on local health services for people with a neurological condition

Presenting evidence on local health services for people with a neurological condition Presentation to the Royal College of Physicians Working Group, by members of the Neurological Alliance Presenting evidence on local health services for people with a neurological condition Amanda Cole

More information

Rehabilitation Network Strategy 2014 2017. Final Version 30 th June 2014

Rehabilitation Network Strategy 2014 2017. Final Version 30 th June 2014 Rehabilitation Network Strategy 2014 2017 Final Version 30 th June 2014 Contents Foreword 3 Introduction Our Strategy 4 Overview of the Cheshire and Merseyside Rehabilitation Network 6 Analysis of our

More information

WSIC Integrated Care Record FAQs

WSIC Integrated Care Record FAQs WSIC Integrated Care Record FAQs How your information is shared now Today, all the places where you receive care keep records about you. They can usually only share information from your records by letter,

More information

Integrated Care Pathway. Management of adult and paediatric patients presenting to the Emergency Department with a suspected first seizure.

Integrated Care Pathway. Management of adult and paediatric patients presenting to the Emergency Department with a suspected first seizure. Integrated Care Pathway Management of adult and paediatric patients presenting to the Emergency Department with a suspected first seizure March 2014 Paper copies of this document should be kept to a minimum

More information

Appendix A - Low Back Pain Scope

Appendix A - Low Back Pain Scope Appendix A - Low Back Pain Scope Low back pain: full guideline DRAFT (September 2008) Page 1 of 10 NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Low back pain: the acute

More information

The new Stroke Nurse Practitioner candidate position at Austin Health

The new Stroke Nurse Practitioner candidate position at Austin Health The new Stroke Nurse Practitioner candidate position at Austin Health The new Stroke Nurse Practitioner (NP) candidate position offered by Austin Health provides an exciting opportunity for a senior nurse

More information

Rehabilitation Following Major Trauma in the North West

Rehabilitation Following Major Trauma in the North West Rehabilitation Following Major Trauma in the North West Acute / early rehabilitation Community based rehabilitation, including vocational aspects Acute / Early Rehabilitation Following Major Trauma Dr

More information

Executive Member for Community Health and Wellbeing. Commissioned Alcohol Services and Current Performance Update

Executive Member for Community Health and Wellbeing. Commissioned Alcohol Services and Current Performance Update TRAFFORD COUNCIL Report to: Health Scrutiny Committee Date: February 2014 Report of: Executive Member for Community Health and Wellbeing Report Title Commissioned Alcohol Services and Current Performance

More information

Neurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, postpolio syndrome, rheumatoid arthritis, lupus

Neurodegenerative diseases Includes multiple sclerosis, Parkinson s disease, postpolio syndrome, rheumatoid arthritis, lupus TIRR Memorial Hermann is a nationally recognized rehabilitation hospital that returns lives interrupted by neurological illness, trauma or other debilitating conditions back to independence. Some of the

More information

Map 1 Statutory specialist services and organisations in England

Map 1 Statutory specialist services and organisations in England Map 1 Statutory specialist services and organisations in England Isle of Man 31 Neuro Rehab Units (YDU) Spinal Injury Centres Brain Injury Services - NHS Brain Injury Service non NHS Stroke Units Regional

More information

HEAD INJURY; THE REHABILITATION PATHWAY. Professor Graham Powell. Professor of Clinical and Neuropsychology

HEAD INJURY; THE REHABILITATION PATHWAY. Professor Graham Powell. Professor of Clinical and Neuropsychology HEAD INJURY; THE REHABILITATION PATHWAY by Professor Graham Powell Professor of Clinical and Neuropsychology The management of head injury will broadly flow along a pathway from Accident and Emergency

More information

Integrated Performance Report

Integrated Performance Report Integrated Performance Report Southwark Social Services and Southwark Primary Care Trust 2003/04 Provisional Indicators Integrated Performance Report: 2003/04 Provisional Indicators 1. Recommendation 1.1

More information

The development of this report was supported by Roche Products Limited Editorial control remains with HEART UK

The development of this report was supported by Roche Products Limited Editorial control remains with HEART UK 1 2 About Heart UK HEART UK is the nation s cholesterol charity and aims to prevent premature deaths caused by high cholesterol and cardiovascular disease. The charity works to raise awareness of the risks

More information

Rehabilitation. Day Programs

Rehabilitation. Day Programs Rehabilitation Day Programs Healthe Care is the hospital division of Healthe. As the largest privately owned network of private hospitals in Australia, we take pride in delivering premium care to our valued

More information