Background The temporary closure of day services due to the pandemic afforded the opportunity to re-model in order to increase accessibility and efficiency. Patients were offered a traditional full day attendance encompassing socialisation, exercise, therapy and a nutritious meal. Patients reported the length of the day was tiring with many too tired to join in afternoon activities. Approximately 15 patients attended per day, with a model that did not allow any flexibility to increase capacity.
Launch a Health, Wellbeing and Rehabilitation (HWR) service which is therapy led, strongly emphasising a rehabilitative approach, promoting positive health and wellbeing.
Operate six days/week (previous model five days/week).
Method Patients are invited to join interactive three hour group sessions for an eight week programme. The variety of groups (disease or symptom specific) enable patients to attend a session bespoke to their individual needs. Groups vary between; educational, symptom management, creative and those specifically for carers, running concurrently throughout the day, supported by volunteers and therapy staff. There is a mixture of patient, mixed and peer support groups. Patient progress is reviewed every eight weeks and those requiring ongoing support are offered an extended programme or an alternative group which including peer support or hospice community sessions.
Results Results have shown a 164% increase in face-to-face contacts (19/20 = 1988 contacts; 20/21 = 5251) and a 30% increase in patient/carer caseload, more than doubling patient/carer attendances per day.
Conclusion In conclusion, the re-modelling of the pre-pandemic day services has resulted in more patients and carers accessing services with a more varied programme on offer. Outcome measures and feedback are currently being analysed to demonstrate the effectiveness of these changes.
Innovation Several hospices reduced or closed their day services programmes permanently in the North-West region, this service redesign has proven that a change in service can increase access to care.
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