Background Both the NHS Five Year Forward View (2014) and Ambitions for Palliative and End of Life Care (2015) advocate developing models of care organised around the needs of patients emphasising personalised care planning, fair access, collaborative working and care coordination. The hospice had an established team of therapists, however, it was recognised that there were gaps in service provision. The existing therapy service was reviewed in 2015 alongside NHS Improving Quality and adapted to provide a seven day service.
Avoid unwanted admissions and facilitate patient’s choices and preferred place of care
Provide ongoing rehabilitation, preventing loss of function and maintaining independence
Facilitate discharge over seven days
Provide moving and handling assessments to reduce falls risk
Increase collaborative working with our seven day community nurse specialist service and health and social care providers.
Method Following the service review, funding for two WTE therapists was secured from our CCG and charity corporate partner to pilot a revised service. This enabled cover to start from January 2016 for weekends and bank holidays and increased response times. Therapists assess and treat patients in both inpatient and community settings and possess core skills and specialist skills specific to each profession.
Results At the three month interim review an improvement in services and outcomes for patients was demonstrated. Most referrals were for urgent community visits to maintain patients at home or for falls prevention on the inpatient unit.
Conclusion Seven day rehabilitation helps to reduce falls and maintains occupational skills. Rapid intervention facilitates discharge planning for end-of-life care at home and supports a person to remain there through provision of equipment and education of patient/carers. Enhancing partnerships with community services provides inclusive care for patients with palliative needs.
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