Clinical Gerontology Services Improving Our Services for Older - PowerPoint PPT Presentation

Development of Clinical Gerontology Services Improving Our Services for Older People in Cardiff and the Vale of Glamorgan Cardiff and Vale UHB

Older People as a Key Priority Population Changes & Needs  Population in Cardiff and the Vale is changing with the average age of people coming into hospital circa 85yrs  Increasing multiple health needs particularly in older people with increasing demand of all areas of health provision  Imperative need for modern, effective and efficient specialist older peoples services centred around the person not the specific condition  Recognise too many older people spend too long in hospital - often results in loss of independence and taking longer to recover  Need to move away from Hospital Inpatient based Long Term Care to support people with maintaining their independence for as long as possible

Framework for Older People Building on the Strategic Themes in the draft Older People’s Framework we recognise;  The central and pivotal place of older people in our services  The expert and focussed care of the older person necessary throughout their care pathway  The need to develop and deliver more continuous and integrated care of older people across our settings and hospitals – supporting rehabilitation  The opportunity to put Older Peoples care at the centre of Medicine in Cardiff and the Vale  Creation of a Clinical Gerontology Directorate in August 2013

Current Service Challenges Whilst progress has been made current services are;  Separate and on isolated sites, impacting on provision of joined up comprehensive care  Operating out of poor quality and isolated buildings environments (Rookwood / West Wing)  Difficult to care for patients who become unwell whilst receiving rehabilitation support due to limited OOH medical cover and medical staff covering multiple sites  Under stress through a stretched nursing and therapies staffing resource to support effective MDT working  Hospital based services not set up in the right way at the moment - not enabled to deliver integrated care across the whole patient journey

“…the current fragmented configuration of services does not support the clinical model we wish to develop and deliver…” The Gerontology Clinical Team  First steps are to change services to provide increased and co- located specialist care for older people on a smaller number of sites in an improved environment  Improve Medical cover in and out of hours to support management of unwell patients without moving them between hospitals  Focus on resources on Rehabilitation and early and consistent input into patients entire pathway, balance Day Services with the potential to increase ECAS, to support move away from traditional long stay community hospital models

What could change?  Increase specialist input at the first point of entry into all acute services (equity across Cardiff and the Vale) P Establish a FOPAL Service at Llandough  Expert presence on both acute sites providing complex frail expertise and rehabilitation whilst patients are acutely medically unwell P Transfer wards to Gerontology at the Heath and Llandough  Create a single specialist hub for Medical, Stroke and Orthopaedic Rehabilitation, with improved medical cover P Transfer Rookwood W6 and West Wing MRU P Increase Medical Rehab inpatient capacity P Transfer West Wing ORU

What could change?  Align our services under one Clinical team wherever possible P Transfer all Stroke services to a single team P Transfer all Orthopaedic care to a single team  Provide Complex Frail care and Comprehensive Geriatric Assessment services from St David’s and Barry Hospitals only P Decrease the overall bed base for CGA/Frail P Close Elizabeth and Neale & Kent wards and increase St David’s capacity  Balance Day Hospital capacity across 3 sites P Transfer Rookwood Day Hospital to St David’s P Increase Barry Day Hospital Capacity  Potential to consolidate and increase ECAS services P Consider option to transfer ECAS to Llandough hub increasing to 10 sessions per week & increasing new patient capacity

What could change?  Ensure fit for purpose MDT input into Gerontology Patients throughout the system P ‘Re - invest’ released staffing resources to support improved Medical cover in, support increasing ward nursing levels and therapy resources P Ensure when older people need acute care they get the same service whether admitted in the Heath or Llandough P Ensure we’re focussing resources on Rehabilitation and putting the experts around the patient not moving patients between services/sites P Start to make changes that support the aims of the Older Person’s Framework and meet the needs of our patients

How will this start to improve our care?  Older people who require hospital care should receive the same expert input throughout their pathways – regardless of where they access our care  Increasing our rehabilitation focus and capacity, and concentrating resources, will make sure we support older people to return to the community and live as independently as possible  Deliver an improved patient experience when in hospital by no longer providing services from poor quality and/or isolated locations  Co-locating our services will mean we have more flexible and robust medical cover, and will stop the need to transfer patients between sites if they become ill

Next Steps Help us by considering and shaping the ideas; 1. Do you think we have missed anything in our vision for older people’s hospital services? 2. Are there any things that you believe need to be taken into account or that we might have missed when assessing the impact of these ideas? 3. Are there other changes to our Specialist Gerontology services you think would further help us to achieve the desired outcomes either immediately or in the longer term?

Contact Details Write to us at; Hannah Mastafa Gerontology Directorate Office Fourth Floor West Wing Hospital Glossop Road Cardiff CF24 0SZ Email us at; talk.to.cav@wales.nhs.uk