cardiff local health board bwrdd iechyd lleol caerdydd rehabilitation workshop 10 th january 2008...
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Cardiff Local Health Board Bwrdd Iechyd Lleol Caerdydd
REHABILITATION WORKSHOP 10TH JANUARY 2008
REHABILITATION WORKSHOP 10TH JANUARY 2008
CARDIFF AND VALE OF GLAMORGAN LHBS COMMISSIONING PERSPECTIVE
Cardiff Local Health Board Bwrdd Iechyd Lleol Caerdydd
REHABILITATION COMMISSIONING VISION
• LHB’s recognise that historic commissioning of current services has been an sequential process driven by access to short /fixed term funding
• This has resulted in a disparate spectrum of service provision with a number of service gaps within the 2 LHB boundaries e.g. ECAS for Cardiff only
• There are limited examples of joint health and social care services
• LHBs have developed commissioning proposals in response to “Framework for General Rehabilitation”
Cardiff Local Health Board Bwrdd Iechyd Lleol Caerdydd
Current Services
Physio
SocialWorker
Domiciliary Care
OT
Family
Diabet-ologist
Practice Nurse
CPN
Cardiol-ogist
GP
DistrictNurse
Podiatrist
RespiteCare
VoluntaryTransport
Physio
SocialWorker
Domiciliary Care
OT
Family
Diabet-ologist
Practice Nurse
CPN
Cardiol-ogist
GP
DistrictNurse
Podiatrist
RespiteCare
VoluntaryTransport
Cardiff Local Health Board Bwrdd Iechyd Lleol Caerdydd
CURRENT CONFIGURATION OF REHABILITATION SERVICES
• Admission avoidance e.g. ART• Expert multi-disciplinary assessment service (ECAS) for Cardiff only
Inpatient rehabilitation:• 142 beds Inpatient rehab (LOS 6-8 weeks)• 112 slow stream/CHC/CHC assessment beds• 5 beds for respite for CHC eligible patients
• Day hospital service
• Discharge expediting services e.g. Community rapid re-ablement / support service /Stroke outreach service
Cardiff Local Health Board Bwrdd Iechyd Lleol Caerdydd
STRENGTHS / WEAKNESSES OF CURRENT COMMISSIONING APPROACH
• Strengths Weaknesses• Significant investment in place Disparate access points• Many services are multi agency Inequality of access across • and multidisciplinary 2 LHB boundaries• Service “silos”• Offers up to 100 bed equiv Short /fixed term funding• Most models of rehab Many services not accessible• in place 7 days /week • Over dependence on hospital• locations ie no community beds
Cardiff Local Health Board Bwrdd Iechyd Lleol Caerdydd
FUTURE COMMISSIONING PRINCIPLES
• To commission care within improved and appropriate patient environments
• To protect acute hospital capacity for patients who require inpatient hospital care
• To commission cost effective care in a range of care settings
• To commission models of care across primary/secondary care interfaces
Cardiff Local Health Board Bwrdd Iechyd Lleol Caerdydd
LHB COMMISSIONING VISION
• All non-hospital services to be accessed via single point• To move significant proportion of current inpatient capacity to
community beds to include CHC/CHC assessment and slow stream rehabilitation
• To commission three element rehabilitation service• Access to 7 day expert assessment service across C&V
boundaries• Day service for elderly patients• Reconfigure rehabilitation / intermediate care services utilising
existing resources to develop five locality based Consultant led admission avoidance / rehabilitation teams to cover Cardiff and Vale of Glamorgan .Teams to incorporate social worker input.
• Commission inpatient episodes of care up to 42 days LOS
Cardiff Local Health Board Bwrdd Iechyd Lleol Caerdydd
Future Services
Physio SocialWorker
Domiciliary Care
OT
Family
Diabet-ologist
Practice Nurse
CPN
Cardiol-ogist
GP
DistrictNurse
Podiatrist
VoluntaryTransport
RespiteCare
Physio SocialWorker
Domiciliary Care
OT
Family
Diabet-ologist
Practice Nurse
CPN
Cardiol-ogist
GP
DistrictNurse
Podiatrist
VoluntaryTransport
RespiteCare