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Financing stroke community rehabilitation Outline of work plan

Financing stroke community rehabilitation Outline of work plan . Healthcare for London: stroke project Martin Hewings. Remit. Support the HfL stroke rehab team by: Understanding how best practise community rehab has been commissioned and funded;

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Financing stroke community rehabilitation Outline of work plan

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  1. Financing stroke community rehabilitationOutline of work plan Healthcare for London: stroke project Martin Hewings

  2. Remit Support the HfL stroke rehab team by: • Understanding how best practise community rehab has been commissioned and funded; • Understanding the financial (and other) benefits of such services; • Drawing lessons from the examples that could be used by other PCTs

  3. Methodology 1 Establishing good practice across London & elsewhere; • Covering: • Community Rehab; • Early Support Discharge; • Support worker/designated person; • Defined review.

  4. Methodology (2) • To answer the following questions: • Is an incremental approach to investment possible? • Are there financial benefits from investment and where do they sit? • How have PCTs funded these services? • Can ranking of investments options be made on financial grounds?

  5. Findings so far • There are significant areas of good clinical practice; BUT not so many examples of good commissioning & financial practice; 2. The Comprehensive Review of Stroke Rehab services across South London IS very comprehensive and a robust model; BUT a number of the assumptions have been challenged including:

  6. Findings so far (2) • Is 45 minute average travel time for each patient high? • Is community rehab suitable for all stroke victims? • Could the clinical care be undertaken by less qualified staff? • Do polyclinics have a role to play in delivering rehab services? The perception is that changing these assumptions could have a significant impact on the financial outcome of the model.

  7. Findings so far (3) • Research elsewhere supports investment in community rehab services: • North Lincs PCT made savings of approx £750k on introduction of an outreach rehab service: • Mc Nee research suggests savings of £325 per patient on implementation of ESD; • Beech, Rudd & others suggest savings of £632 per patient on implementation of ESD; • Additional evidence being sought from NHS Hampshire, Manchester, Coventry & Solihull.

  8. Further work required • Identify more examples of good clinical / commissioning practice. Understand how funded; • Consider updating South London Comprehensive review for revised assumptions; • Look further at commissioning, particularly Joint Commissioning, to ensure full costs & savings are identified.

  9. Conclusions to be reached on: • Incremental approach to investing; • Identify financial benefits from investment, wherever they sit & over whatever timescale; • Consider a ranking of investment options on financial grounds; • Review methods of financing developments.

  10. Interim Conclusion • On the basis of the work completed to date it would seem that: • Community based stroke rehabilitation services can be financially viable and cost effective. • The underlying issue is how to free up resources to invest in the services.

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