non-msk Out-patient Physiotherapy VHK 1200 In-patient Physiotherapy VHK

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1 Axis Title no.of patients Item Access / Performance Clinical governance report Therapies and Rehab July 215 Physiotherapy New : Review = 1:3 New : Review = 1:3.5 In-patient Physiotherapy VHK Mar Apr May NEW RETURN TOTAL non-msk Out-patient Physiotherapy VHK NEW RETURN TOTAL Speech and Language Therapy Occupational Therapy New: Review =1:3.2 New :Review =1: 2.6 Speech and Language Therapy New Review Total Occupational Therapy VHK Total New Assessments Total Reviews Total Direct Contacts

2 Dietetics Orthotics ( excluding drop off and pick up activity) New: Review = 1: 2.5 New :Review = 1: Dietetics VHK New Review Total Orthotics New Pts Reviews Total Targets National 4 week AHP target Waiting lists at end May 215 QMH / DB VHK / RWMH Musculoskeletal 11 week 6 week but now assisting list at Glenwood Continence and Pelvic 4weeks 3weeks health Respiratory No waiting list 1 week Lymphoedema No waiting list No waiting list Orthotics 4 weeks 5 weeks 2.Safe Incidents March to May T&R incidents March to May 215 Infrastructure (Accommodation / Availability / Staffing) Patient Information (Records / Documentation / Tests / Results) Personal Accident Negligible Minor

3 There were 3 incidents recorded across therapies and Rehab. Incident 1 related to a piece of equipment ordered and although signed for in portering did not reach Rehab, the company sent another free of charge. Incident 2 related to 3 patient records going missing in the orthopaedic department after clinic. The notes turned up in medical records 3 weeks later. Incident 3 was an Occupational therapy student who fainted during the Trauma meeting due to overcrowding in a warm room. Management of adult patients with rigid cervical collars The launch of the SOP is still in delay. The e-learning package is 99% complete and the next stage is to test it before it is launched. In anticipation of the launch the SOP for Fife has been shared with both Lothian and Tayside tertiary services Health and safety The Health and safety systems for therapies and Rehab have been reviewed taking into account the move of community services onto the QMH site. The management walkabout paperwork has been altered to amalgamate Patient Quality indicators with advice from professional bodies. All clinical and Generic Risk Assessment have been updated and 3.Effective Dementia The Activity boxes have been restocked Occupational therapy is piloting activity groups for patients with dementia on the medicine for elderly wards using volunteers. The volunteers have been recruited from 6 th yr pupils in Bell Baxter highs school and they will work with a Senior OT. Physiotherapy exercise classes These have been introduced across the medical wards to facilitate more targeted Physiotherapeutic interventions to patients with multiple co-morbidities resulting in a physical deterioration. Flexible Working Respiratory Physiotherapy The surgical / Respiratory team utilising existing resource piloted a 3 month full 5/7 day rota for the Respiratory team from 19 th January 215. Whilst there was enhanced visibility of physiotherapists at weekends there was a notable quality compromise of the clinical weekday service; cancellation of amputee classes, and reduced rehab input to post operative patients. There was also an impact to the nonclinical demands of the team; cancelled training sessions, cancelled tutorials, incomplete eksf completion. In order for a 5 out of 7 day respiratory/vascular service to be delivered sustainably it would need an uplift of resource. A business case using the data gathered from the project is being written.

4 Orthopaedics As a result of the 7 day working PT and OT are now meeting the Hip fracture standards in terms of timeliness and equity across 7 days. Integrated Assessment Team Following the urgent care redesign event PT and OT are working with medical and nursing colleagues to review the integrated assessment team at the front door in terms of numbers and composition. The plan is that all patients who present to the front door either via the ED or the Admissions Units via GP referrals will be screened for frailty. Where there is a positive frailty screen, a comprehensive multidimensional interdisciplinary assessment (the principles of CGA) be commenced where clinically appropriate within 4 hours of admission and no later than 14 hours of admission if admitted overnight. The team will follow a discharge to assess model therefore this review is also taking into account the need for rapid response within the community teams to follow u the frailty assessment. Sickness absence OT PT A&C AHP Managers Total Average Mar Apr May Staffing levels The vacancy factor in Physiotherapy has reduced from 3% reported last quarter to 2% currently. We have redefined rotations and have worked with HR to secure internal appointments of some staff previously on bank. 4. Person Centred Clinical Strategy A large piece of work has been undertaken by senior staff across Therapy and Rehab to articulate the clinical strategy for AHP s in acute in response to the NHS Fife clinical Strategy. This has now been ratified and is being cascaded to staff across the services. The actions and evidence monitoring required to meet the clinical strategy will be taken forward both by individual services and as a collective. AHP Framework Document - draftv4.pptx

5 Complaints A total of 5 complaints have had AHP involvement. 3 of these were General ie information as to the type of AHP care,frequency of treatment and rational behind decisions made was given as part of a multidisciplinary response. A further 2 complaints related directly to AHP services No of complaints Action required / Taken 3 General No Case to answer but feedback is given to staff on lessons learned 1. Communication Issue was raised in regard to families being able to contact AHP staff ( as there is no dedicated AHP staffing to wards). Nursing staff do have contact numbers but as part of the clinical strategy all AHP services are looking at displaying contact information on all wards. 1. Appointment management There was ambiguity around how these appointments were to for Orthopaedic Physiotherapy be made at QMH and a misunderstanding that orthopaedic clinic practitioners appointments where an AHP specialist practitioner was the professional running that clinic were not managed by main reception. This has been rectified Compliments we have been notified of letter of compliment received into Acute services relating to thoroughness of the service. Concerns No concerns have been raised with the services Carol Duncan-Farrell Head of Therapies and Rehab/ Head of Physiotherapy Acute services, NHS Fife

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