Securing Resources for Neurological Care and Rehabilitation in a Recession. Áine Carroll Clinical Lead, Rehabilitation Medicine Programme

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1 Securing Resources for Neurological Care and Rehabilitation in a Recession Áine Carroll Clinical Lead, Rehabilitation Medicine Programme

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4 Clinical Strategy and Programmes Clinical Strategy and Programmes has been established to improve and standardise patient care throughout the organisation by bringing together clinical disciplines and enabling them to share innovative solutions to deliver greater benefits to every user of HSE services.

5 Objectives: To improve the quality of care we deliver to all users of HSE services To improve access to all services To improve cost effectiveness

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7 Rehabilitation is one of those words which have meaning for most people who use them but the meaning of which is not only universal but may vary from sentence to sentence with the same user Licht S 1968

8 Rehabilitation a set of measures that assist individuals who experience, or are likely to experience, disability to achieve and maintain optimal functioning in interaction with their environments.

9 ICF

10

11 The rehabilitation process

12 Benefits of Rehabilitation Improve health outcomes, Reduce costs by shortening hospital stays Reduce disability, and improve quality of life Rehabilitation need not be expensive. Rehabilitation that begins early produces better functional outcomes for almost all health conditions associated with disability

13 Rehabilitation: what do we know? Limited investment Large gaps in the service provision Higher rates of disability = greater potential need for rehabilitation Few rehabilitation personnel Broad social and financial implications

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15 Ireland National Rehabilitation Hospital has 109 beds and 6 Consultant Specialists in Rehabilitation Medicine. Internationally, the minimum recommended number of beds is 6/ 100,000 population with 1.5 consultants/ 250,000. This equates to 254 Post acute Rehabilitation beds and 27 Rehabilitation Consultants. There is currently a major shortage of Rehabilitation beds and rehabilitation expertise.

16 What contributes to disability? Participation restriction is the product of various inter-related factors. At the core is a combination of attitudes, access, education, and employment. Whereas consultation, funding, progressive policies and rehabilitation could promote independence and improve outcomes for people with a disability, such actions require infrastructure and political will in circumstances where, too often, both are lacking.

17

18 The missing link

19 The way forward Policy, legislation and regulatory mechanisms Financing Human resources Service delivery Assistive technology Research and evidence-based practice.

20 Would you tell me, please, which way I should go from here? Alice asked the Cheshire Cat. That depends a good deal on where you want to get to, said the Cat. Lewis Carroll, Alice in Wonderland

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22 What's happened in the last year??

23 World Report Content overview Understanding disability Disability a global picture General healthcare Rehabilitation Assistance and support Enabling environments Education Work and employment The way forward

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25 Rehabilitation Medicine programme National Clinical Strategy and Programmes Directorate, HSE

26 Progress to date Working group Consultant Clinical Advisory Group Clinical Lead appointed for Regions, SCI, POLAR

27 Workstreams of the Working group: 5 subgroups looking at : Model of Care ABI SCI POLAR Progressive neurological conditions

28 Each subgroup will have the following workstreams: Service mapping (although the Regional MCRNs may do this) Development of Quality standards, care pathways and protocols Clinical governance Patient involvement and information provision IT and evaluation (audit)

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30 Aims for 2012 Develop regional networks, local rehab teams and associated protocols, pathways and bundles Develop four regional specialist inpatient and outpatient units In association with other programmes define an enhanced model for community based rehabilitation services.

31 Service Delivery: Hospital services

32 Service delivery: Disability Services

33 4 HSE Regional Service Plans Region DNE DML Rehabilitation SOUTH West

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39 Help required Literature reviews Self management Local champions

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