Agenda item

14:45

Oxford Health will report back on the performance, outcomes and next steps following the Stroke Rehabilitation Services Pilot. It includes information on the plans to provide intensive care at home, on the County Council therapy services, and the plans for expanding the ESD services. It also seeks further evidence about issues about the Services highlighted by Healthwatch Oxfordshire (JHO13).

Stuart Bell, Chief Executive, Oxford Health, presented a report (JHO13) which reported back on performance, outcomes and the next steps following the Stroke Rehabilitation Services pilot. He stated that the move had taken place in February from Witney to the Abingdon site. Since then it had been found that the length of stay had reduced which meant that patients were able to go home more quickly.

Attending alongside Mr Bell was Dr Robbie Dedi, Deputy Medical Director, OH and Sara Bolton, Allied Health Professions Lead, OH.

Cllr Rooke reported that some members of the Committee had made a very interesting visit to the Stroke Unit and had found the staff to be very engaged in their work. Questions asked and responses received were as follows:

In response to questions from members regarding a recent Healthwatch Oxfordshire report which had stated that a number of patients at Abingdon were waiting for a discharge package for occupational therapy and physiotherapy; and 70 patients were waiting for assessment, Sara Bolton stated that therapy was provided on the Unit and exercises were also given for patients to do at home on leaving the Unit. She added her awareness that there were waiting times in the Community Therapy service, stating that the Team would provide more information to the Committee on this subject.

In relation to a question asking at what point did a patient begin to deteriorate without physiotherapy, Sara Bolton stated that it depended upon the individual’s treatment plan. If a patient required therapy immediately following discharge then it would follow through as a seamless process. Sometimes hospital patients were given extra therapy. Dr Dedi added also that even without therapy, the level of functioning deteriorated the longer a person was in a hospital bed. Therefore, getting these patients home would improve their situation.

In response to a question about whether there had been input from families /carers regarding the travel aspect of the move, Dr Dedi stated that there had been no specific complaints or consistent carer feedback regarding the transfer. The patients were made aware of the benefits of co-locating which were that they would be better cared for and would be moved back to their home more quickly.

A member asked about the costs of recruiting nursing staff. Sara Bolton responded that the Trust continued to have a very active recruitment process which had been extended to embed agency staff further into the Team. This, however, was not a long - term plan. Also, in response to a question about how many staff had left the service as a result of the transfer, how many had transferred and how many had returned, Sara Bolton stated that she did not have the current details with her of who had left the service. However, four support workers had discussed a transfer to Abingdon which would create a good Team.

 The Chairman requested at this point that representatives returned to a future meeting once the evaluation pilots had been completed, adding that the Committee would be interested, in particular in the patient feedback and the impact of the closure on Witney Hospital, on, for example, staffing.

A member asked if being treated whilst in hospital strayed into a grey area with regards to means testing. Dr Dedi responded that stroke specialists/therapists were present at the Unit. Specialist therapy was not related to means testing. Therapy reduced the need for ongoing care and should minimise the need for ongoing treatment.

The representatives were asked when the pilot was scheduled to end and what criteria was in use to measure success. Dr Dedi responded that the Trust had been confident at the start of the scheme and even within a few months it had been demonstrated that outcomes had been met and it had showed its worth. He added that there were many reasons for continuing with the pilot, and to continue with the arrangement thereafter.

The Chairman stated that a further report on the outcomes would be useful for assessment purposes. Dr Dedi responded that those receiving intense and regular therapy were difficult to measure as the numbers were too small. However, the Trust would be measuring staff, friends and family outcomes and clinical outcomes; and would also be reporting against the national data. In relation to a comment from a member stating that expediency would be welcomed as it was understood that the Oxfordshire Community Therapy Unit was causing many problems, Sara Bolton reported that the CCG was in the process of commissioning a stroke review to determine whether the correct rehabilitation model was in place, which included OCE.

At the close of the session, the Committee AGREED that it was encouraged by the early indications, but needed to see the outcomes-based data of the pilot and the service’s impact on the County before taking a final decision. It therefore reserved the right to finalise the review until a presentation was given on the final data, as indicated above.