CUMBRIA. Maryport Therapy team (formerly STINT) Contact details: Liz Sim-Team Lead (OT) Tel: Fax:

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1 CUMBRIA Maryport Therapy team (formerly STINT) Liz Sim-Team Lead (OT) Tel: Fax: Short term intervention D/C planning from community hospitals Rehab centre 2 days a week PD clinic Neuro rehab by default (not specifically trained, but experienced) 1.5 OTs, 1 Physio (neuro knowledge), part time SLT, part time social worker, part time assistant practitioner. All patients covered by Maryport health services. North of Allonby, across to Dearham, down to Flimby. Phone and fax All conds-aside from those presenting with major cognitive problems and palliative-get seen by palliative care OT Dependent upon capacity. Unable to see people straight away without prior notice, but do prioritise urgent referrals Dependent upon rehab needs and treatment programme. If necessary could be seen most week days by rehab assistant. Average pt discharged seen 3 x week by therapists. Officially 6 week max, but dependent upon treatment goals. Pts with long term conditions can be seen for longer. using the prescription system and urgent prescriptions can be made if family can collect. Can do hospital discharge visits if required Work closely alongside District Nurses

2 Eden/Penrith Community Response team (formerly STINT) Margaret Nelson (Team Lead) Adele Prescott (B6 OT) Tel: Fax: Multi disciplinary Focus on admission prevention and safe hospital discharge. 1physio, 1 OT. 3 rapid response nurses, 2 assistant practitioners, 1 social worker, number of rehab assistants Whole of Eden valley to Southwaite, Armathwaite, Patterdale, Kirby Stephen Verbal and Contact 1 All. Don t usually see palliative/end of life but work alongside palliative care team. Not specifically neuro rehab but see a lot of people with MS & PD No Max 4-5 visits a day (rehab assistants), therapists 1x week Short term. Max 6 wks (can be flexible). If long term, need can be reviewed and they will refer onto long term care. -alongside rapid response nurses Good links with GPs and nurses in team can monitor people medically at home

3 Copeland STINT Whitehaven (N) & Egremont (S) Karen Lomas (Team Lead-Physio) Tel: (Cleat Moor Office) Fax: Rapid response nurse (referral line) Tel: Short term intermediate care 3 OTs, 2 physio, part time SLT, 2 social workers, rapid response nurse, 2 assistant practitioners STINT-must have a rehab need Copeland split into North & South -Allerdale Verbal and fax Contact All as long as have a rehab need. Occasional palliative pt No Max 5xday (assistant practitioners) 1 x wk (therapists) Max 6 wks (can be flexible if needed). Rapid response nurse in team is able to assess rehab potential post hospital discharge. Initial assessment. with Rapid response Rapid response nurse in team is Melanie Dustin

4 Cockermouth therapy team (formerly STINT) Tanya Coates (Therapy Lead - Physio) works 2 days week Tel: Fax: Short term community rehab 1.5 physio, 4 OTs, 2 assistant practitioners, home care practitioners (enabling carers) Wigton-Great/little Broughton-Lamplugh Verbal and fax Contact 1 All inc palliative and neuro rehab needs No Limited. Max 3x week. Usually 1-2 x week 42 days max (can be flexible dependent upon need) -provided notice given

5 Brampton Community Rehab service Bridget Robinson (OT) Sarah Grundy (Physio) Tel: Fax: Must have a rehab need. 1OT, 1Physio, 1 Assistant practitioner. Access to Support workers Brampton-Roadhead-Gillsland-Weatherall-Carlisle Verbal and Fax Contact 1 All. Not end of life care-seen by hospice at home service Dependent upon capacity. Comm r/fs take precedence. Max 4xday (support workers) Until rehabilitated (6 wks +)

6 Wigton CRT Tel: Fax: Community resource team 2physio, 3OT, 2part time SLT, 1Support worker Allonby-Silloth-Aspatria-Dalston-Caldbeck Phone and fax contact 1/specific referral form All inc palliative & neuro rehab No 4x day max with support worker Short term. 6 wks max Admin: diane.blackburn@cumbria.nhs.uk

7 Workington STINT & rehab centre (merging) Nia Fletcher (physio) Mob: Fax: Anna Lawler (neuro physio out pts at Workington hospital) Tel: Inpt, community & outpts 3OTs, 3physio (1vacancy), 1part time SLT Workington), 3 rehab assistants, nurse, carers, Social worker and support workers Workington area Mob or fax All. Physio sees palliative (OT doesn t as palliative OT) No Max 5 x wk rehab assistants 6 wks-can be flexible dependent upon whether goals resolved -with notice Service currently going through change-will update when clarified

8 Palliative care OT-Workington Lesley Storer Rowanne (TI) Tel: Fax: Palliative care team OT & TI (Mon-Thurs) -work with nurse specialists in hospital and community Copeland-Allerdale. W Cumbria Telephone first then fax contact 1/standard R/F form (Also provides bereavement support for children) All with palliative need. 80% oncology Depends upon need. Unable to do rehab plans with people as no capacity Depends upon individual cases Offer specialist interventions eg relaxation, breathlessness and fatigue management

9 Neuro-rehab inpatient ward Elm C. Carlisle Infirmary Occupational Therapy Department Tel: Neuro rehab inpt (plus access to OT outreach) N Cumbria inpt Telephone 17+ Mainly stroke and brain injury. Occasional brain tumours Can be Have neuro-rehab outreach OT-Richard Wamsley (below) and Neuro rehab physios -Jo Howard & Debbie Berg (outpt)

10 N. Cumbria Neuro Outreach (Stroke) Richard Walmsley OT Fax: Mainly stroke rehab (can take some other neuro conds) Shares an assistant with stroke rehab team Carlisle-Brampton Fax written referral/telephone to discuss individual cases 10+ Mainly stroke, other neuro conditions None Varies-can be one offs to a few months Dependent upon need If appropriate

11 West Cumberland and Workington Community Hospital neuro physio service Team lead Steven Atkinson Tel: Inpt, outpt and community neuro physio. 3physio, part time assistant Whitehaven & Egremont Phone call All neuro (good links with MND team at RVI) -10 wks at present (Aug 2013) Max 3x week. Usually 1x month Variable-dependent upon treatment goals. Usually do a 6 month R/V to ensure pt s needs met. Walking aids Have done-ring prior Flexible service-call to discuss individual cases. Not a fast response service

12 Penrith & Eden Community hospital neuro outreach team Tel: Fax: Community & inpt. Early supported discharge 6 Physio, 7OT, 2SLT, 4 generic rehab assistants Penrith-Eden-Tebay Telephone and fax Contact 1 All-not palliative No Max 3-4x day (rehab assistants) Depends upon needs-usually 2-3 wks Kate Buckton (Physio) Neuro outreach team

13 Cumbria Community Acquired Brain Injury Team (CCABIT) Vicky Reay (Case manager) Carlisle Tel: Fax: Kendal Tel: Fax: Community rehab 4 OTs, 1 physio, 1dietetics, 1 SLT, 3 Care managers, 1 clinical psych, 1 psych assistant. Whole of Cumbria (as long as pt has a GP in Cumbria). 2 offices (Carlisle & Kendal) Specific referral form 16+ Mainly traumatic brain injuries can see brain tumours No Dependent upon need Once goals pathway/review process complete See leaflet

14 Southlakes (formerly Kendal) STINT Sue Wilkinson (OT) Tel: Fax: Comm rehab and rapid response to prevent hospital admission/safe discharge home. Have 2 rehab units (step down services). 3 OTs, 6 Physios, 2 Social workers, 6 Nurses, 4 therapy assistants, 1 Assistant practitioner. Southlakes (Kendal-lake district) If discharge from hospital ward- through Strata Rapid discharge A&E- telephone All-not palliative. Neuro-rehab in a general sense although not specially trained No Therapy assistants can do rehab daily. OT/Physio on average 2-3 x week Usually 3-4 wks can be flexible -if from RVI must be am D/C. Can also complete EVs if families/carers etc can provide access prior to D/C Can coordinate POC.

15 Carlisle Community Rehab Team (formerly STINT) Tel: Mob: Fax: Community Rehab-recently amalgamated with dom physio. Have OT,physio, Social workers, carers, rehab practitioners Carlisle-Longtown Phone or Fax contact 1 All-as long as rehab need. Can see palliative. If long term cond gets referred to adult social care. Although Comm R/Fs take precedence Often as required Dependent upon patient with notice. If from Newcastle must be am d/c

16 Alston community hospital domiciliary physio Madeleine Aynsley. Tel: (works at Alston Wed) based at Penrith Therapy dept rest of time. In pts (6 bedded ward), outpts and community. 1 Physio, 2 generic rehab assistants Alston Moor-Nenthead-Garigill-Slaggyford Fax/phone All inc neuro-rehab (If unable to get to Penrith for neurooutreach) No Depends on individual circumstances Depends on individual circumstances-on average 6-8 wks Rehab assistants can provide equip

17 Eden Valley Hospice Jan Spencer (OT) Fax: Palliative care OT (Inpatient and day care, but mainly community based) Part time assistant practitioner Carlisle-Longtown-Wigton-Espatria. Boundaries unclear-happy to see if not too far out Phone call and contact 1 (any HCP can refer/pts can self refer) All palliative Not at present, although can be a 3 day wait for discharge visits so notice required. Will prioritise urgent cases. Regular contact Varies Band 5 OT with special interest in palliative care Mark Mc Cready covers Penrith

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