Neurological Rehabilitation Redesign

The Community Neurological Rehabilitation Team have been working very hard to redesign the service we provide. This was something we needed to do because patients who were trying to access our service were having to wait a very long time to see us and we were not always able to give the same level of service to all of our patients.

We have been focussing on how we can use the resources that we have as efficiently and effectively as possible to meet the needs of our patients.

Our goals are:

• To provide high quality and timely neurological rehabilitation to Leeds patients.
• To ensure timely equitable access for all that need community neurological rehabilitation.
• To work collaboratively with partners in Leeds.

The economic climate means that we do not have any additional resources at this time to increase what we offer to patients. So we are taking a phased approach to redesigning the service. Phase 1 started at the end of June 2023. During this time we will identify areas which can be improved for patients which will form phased 2 and 3 of the redesign process.

For more information about what the service will look like in phase 1 please see the Community Neurological Rehabilitation Team page.

• QThings we have achieved so far

  We have spoken to patients and carers, other professionals who work with us and our own staff to find out what is most important to them. Some of this information can be found in the 'You said we heard' section below.

  We have looked at how we are spending money to provide our services and tried to identify if there are any ways we could provide the same quality service in a more efficient way.

  We have looked at how we have supported patients in the past, what they have wanted to support with and how we have provided that support to see what the service should focus on. 

  We have looked at the resources we have available and what all patients need from us to ensure we provide an equitable offer to all patients.

  We have looked at what we might not be able to provide in phase 1 with the staff and resources we currently have but that we would look at in the future.

  We have improved our referral process into the service so it is easier for people to access the team when they need it.

  We have started to develop information about the service in a variety of formats eg leaflets and videos.

  We send clear information to patients about how long they will be waiting and what they can expect to receive from the service once we are able to see them.

• QYou Said We Heard

  You Said We Heard - Information

  You said	People want better communication whilst waiting to access the service, including length of expected waits and details of the service offer and what people/carers can expect. Following discharge, people didn’t like the word ‘final review’ and would like the option of support post discharge.
  What we are doing	We will look to improve our communication with people on the waiting list and ensure we use a variety of formats to do that. We will provide details of the current service offer, and set expectations regarding elements to be delivered at home / in other community settings. We will not use the word ‘final review’. We will ensure that patients and carers are sign posted to voluntary third sector organisations and peer support groups once therapy/treatment has finished for further information and support. Digital tools will also be provided which will help with future self-management.
  How can you help? (How can patients, carers, members of the public help)	Let us know what a “good discharge” would look like to you. We are always keen to hear feedback as your views and experiences can help shape the service. In addition, any ideas on which support groups/organisations you would find useful are always welcome.

  You Said We Heard - Accessibility

  You said	If inpatient rehabilitation is needed people prefer to be seen in local hospital and community settings rather than big general city hospitals. People need to be given a range of options of how to access the service
  What we are doing	A location/offer for in-patient stays for rehabilitation has not been identified yet, but we will not be looking at a big general city hospital, for provision of this. We want to make the referral process as easy as possible. The referral form will be reviewed to ensure it is accessible and easy to use for health care professionals and that they are aware of the service. For re-referral we will provide you with clear information on how to come back to the service if you need to following discharge.
  How can you help? (How can patients, carers, members of the public help)	Talk to the service about the re-referral process once you are discharged and the range of options available. Make sure you keep hold of the information to contact the service if you need to.

  You Said We Heard - Quality of service

  You said	Carers, friends, and families want to be more involved and would value more flexible visiting times for inpatient stays (if inpatient rehabilitation is needed).
  What we are doing	We will look at doing some more engagement around this area to identify specifically what carers, friends and families value about being more involved and how we can improve inpatient stay experience when this is needed.
  How can you help? (How can patients, carers, members of the public help)	Help us identify what being involved looks like to you to help shape this.

  You Said We Heard - Equality of access

  You said	People from diverse communities need more assurance about what to expect before they arrive for their in-patient stay and / or enter the service.
  What we are doing	A detailed communication plan around the new service model will be drawn up which will include a variety of forums/formats/languages to ensure it is accessible to all. We will also look at the idea of filming a video of what to expect which can be sent to patients.
  How can you help? (How can patients, carers, members of the public help)	Get involved and tell us what you think of our communication plan and help shape what the video could include.

   

• QWhat we are still working on in Phase 1

  We will continue to work on more information for patients, in a variety of formats, about the different things we offer and how patients can support themselves to manage their own conditions.  

  Our waiting times remain longer than we would like at present. We are working towards patients waiting no longer than 4 weeks for priority or 12 weeks for routine access to the service.

  We are working to finalise the full details of the community rehabilitation bed for when patients need to be assessed or treated over a 24 hour period. This will be in a community setting as this was stated to be important by our patients and carers. We will also work with the setting to ensure family and carers can be involved when the patient is staying in a bed away from home for rehabilitation.

• QWhat we will be doing in the future

  During phase 1 we will be having more conversations with patients and carers to see if we getting it right or how we can improve.

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