Neuroscience quality and safety 2014 organisational audit results



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London Neuroscience Strategic Clinical Network Neuroscience quality and safety 2014 organisational audit results Dr Jo Jarosz Date Clinical Director, King s College Hospital NHS Foundation Trust Clinical Lead, London neuroscience quality and safety working group 18 March 2015

Quality and Safety Workstream Members Dr Bal Athwal Consultant Neurologist Royal Free Hospital NHS Foundation Trust Heather Campbell Clinical Lead & Head of Neuro Rehab Pathway Guy s and St Thomas NHS Foundation Trust (community ) Dr Jozef Jarosz (lead) Clinical Director / Consultant Neuroradiologist King s College Hospital NHS Foundation Trust Dr Harri Jenkins Consultant Neurologist Imperial College Healthcare NHS Trust Dr Nick Losseff Clinical Director London Neuroscience Strategic Clinical Network Katie Nichol Project Manager London Dementia and Neuroscience Strategic Clinical Networks Michael Oates Quality Improvement Lead London Neuroscience Strategic Clinical Network Mr Jonathan Pollock Clinical Director / Consultant Neurosurgeon Barking, Havering & Redbridge University Hospitals NHS Trust Dr Sanjay Wijayatilake Consultant in Neuro Intensive Care Barking, Havering & Redbridge University Hospitals NHS Trust Dr Oliver Foster Consultant Neurologist St George s Hospital NHS Foundation Trust Dr Michael Dilley Consultant Psychiatrist South London and Maudsley NHS Foundation Trust

London Neuroscience Strategic Clinical Network

Neurosciences Care Neuroscience Regional Centres 6 Specialist Neurology Centres 2 Acute General Hospitals 22 Community Rehabilitation Primary Care Social Care Rehabilitation

Quality and Safety Workstream Audit Organisation Process Outcome

Quality and Safety Workstream Audit Organisation Process Outcome

Neurosciences Providers Acute General Hospital Acute General Hospital Social Care Neuroscience Regional Centre Primary Care Acute General Hospital Community Rehabilitation

Audit Questions Staff Provision Infrastructure Protocol and Transfer Standards Communications and Training Standards Patient Information and Support Services Database and Registry Audit and Research

Neuroscience Centre Questions

Responses Regional Centre 100% Specialist Centre 100% Acute General Hospitals 52%

Staff Provision-Results

Staff Provision-Results

Staff Provision-Results

Staff Provision-Results

Infrastructure-Results

Infrastructure-Results

Infrastructure-Results

Infrastructure-Results

Protocol and Transfer Standards-Results

Protocol and Transfer Standards-Results

Protocol and Transfer Standards-Results

Protocol and Transfer Standards

Protocol and Transfer Standards-Results

Protocol and Transfer Standards-Results

Protocol and Transfer Standards-Results

Communications and Training Standards-Results

Communications and Training Standards-Results

Patient Information and Support Services-Results

Patient Information and Support Services-Results

Database and Registry-Results

Database and Registry-Results

Specialist Community Rehabilitation Specialist community neurorehabilitation service Regular involvement with specialist inpatient unit multidisciplinary team meetings. Coordinated care planning with specialist inpatient rehabilitation units. Barking and Dagenham Community Rehab Service Barnet Community Neurological Conditions Management Team Bromley Specialist Community Rehabilitation Neurology Team Camden Community Neuro and Stroke Team Central London Neurorehabilitation Community Team Ealing ENable Community Services Greenwich Community Neuro Rehabilitation Team Guy's and St Thomas' Community Health Services (Lambeth) Guy's and St Thomas' Community Health Services (Southwark) Havering Community Rehabilitation Service Hounslow and Richmond Community Neuro Rehabilitation (Hounslow) Richmond upon Thames Community Team

Specialist Community Rehabilitation Specialist community neurorehabilitation service Access to a consultant in RM Neuro-psychology provision Clinical psychology provision Neuro-navigator Barking and Dagenham Community Rehab Service 0 0 No Barnet Community Neurological Conditions Management Team 0.5 0 No Bromley Specialist Community Rehabilitation Neurology Team 0.5 0 No Camden Community Neuro and Stroke Team 0 2 Yes Central London Neurorehabilitation Community Team 2 0 No Ealing ENable Community Services Null 0.4 0 No Greenwich Community Neuro Rehabilitation Team 0 0.5 No Guy's and St Thomas' Community Health Services (Lambeth) 0 0.5 No Guy's and St Thomas' Community Health Services (Southwark) 0 0 No Havering Community Rehabilitation Service 0 0 No Hounslow and Richmond Community Neuro Rehabilitation (Hounslow) 0 0 No Richmond upon Thames Community Team 0.4 0 No

Conclusions No systematic application of organisational frameworks to allow remote advice, cover and transfer of patients

Conclusions No systematic application of organisational frameworks to allow remote advice, cover and transfer of patients No agreement on protocols for management of acute neurological emergency

Conclusions No systematic application of organisational frameworks to allow remote advice, cover and transfer of patients No agreement on protocols for management of acute neurological emergency Variation in both personnel and infrastructure

Conclusions No systematic application of organisational frameworks to allow remote advice, cover and transfer of patients No agreement on protocols for management of acute neurological emergency Variation in both personnel and infrastructure Specialist ownership is lacking

Conclusions No systematic application of organisational frameworks to allow remote advice, cover and transfer of patients No agreement on protocols for management of acute neurological emergency Variation in both personnel and infrastructure Specialist ownership is lacking

Thank you for your attention www.londonscn.nhs.uk/publication/london-neuro-quality-and-safety-organisational-audit/