Historically in NHS Forth Valley there has been very limited specialist rehabilitation services for patients who have experienced major trauma or have complex neurological healthcare needs. As part of the National Major Trauma Implementation plan, funds were provided to every health board in Scotland to enhance rehabilitation services for these people.
Using the funding available, as part of a local test of change, four specialist rehabilitation beds were created for people who had experienced major trauma. This was then expanded to a 10 bed Specialist Rehabilitation Unit (SRU) to provide specialist rehabilitation for patients of all ages with more complex rehabilitation needs.
What happened next?
- Following a successful test of change, additional health board funding was invested to increase AHP, nursing and neuropsychology levels within the Specialist Rehabilitation Unit.
- Due to capacity pressures during the Covid-19 pandemic, the Unit was moved from Forth Valley Royal Hospital to the Thistle Suite in the Bellfield Centre at Stirling Health and Care Village.
- Clinical cover is currently provided by ANPs and staff visit FVRH to assess new patients referred to the service.
Where are we now?
- 10 specialist rehabilitation beds (provided in individual ensuite rooms) are available within a homely environment where patients and their families have access to a range of outdoor and social spaces.
- An intensive multidisciplinary 24 hour rehabilitation service is now in place supported by weekly multidisciplinary team, patient and family meetings.
- A goal setting approach, including individual goal folders and regular review meetings, has been implemented along with supported discharged planning arrangements, including day and overnight passes.
- Major Trauma Rehabilitation Coordinators (MTRC) make referrals for all appropriate trauma patients and maintain close links throughout their care.
- Links with wider rehabilitation networks and voluntary organisations have been established.
Developing an in-reach service at FVRH
An in-reach service is being developed to provide early and intensive rehabilitation for patients in Forth Valley Royal Hospital who are not medically suitable to be transferred to a community hospital or who are waiting to be transferred to the Unit.
The aim of this service is to work alongside existing rehabilitation staff to optimise rehabilitation in an acute setting by providing assessment, advice and therapy sessions.
Future Plans
So far, the service has been unable to recruit a Consultant in Rehabilitation Medicine as there are national shortages in this speciality and there have also been difficulties in accessing specialist medical review and advice, due to the Unit’s community-based location.
The aim for the future is to have these services in place to enable more patients to be able to be transferred to the Unit at an earlier stage.
Feedback from Local Patients
“I really cannot comment on what it would have been like prior to specialist rehabilitation, I can only surmise. It was a complete wrap around service I was provided with, this was fundamental to the pace of my recovery.”
“I would also like to pass on a message to the Chief Executive; the team have done an amazing job. It’s the NHS at its very best. It would be very short sighted if you do not continue to expand the Specialist Rehabilitation Service.”
“Staff 100% took account of what mattered to me, they knew what my goals were, they showed me how to achieve them, and how to break those goals down to make them achievable. I was able to talk to any member of staff, my needs were always met.”
