INAUGURAL NI AHP CONFERENCE 2013:

1. INAUGURAL NI AHP CONFERENCE2013: “AHP’s – Transforming Your Care” Wednesday, 23 October, Lagan Valley Island, Lisburn

2. Enabling patients to return to their own home and Reducing length of Hospital stay • Margaret Moorehead • Assistant Director Allied Health Professions

3. Improved Patient flow is essential to support A&E • Reducing Length of Stay in Hospital Wards • Champion patients returning to their own home where possible • Identify and remove barriers to discharge

4. SET Winter Pressure Pilots 12/13 • Targeted 7 day Multi Disciplinary Team working in the Ulster Hospital • Community Expeditor Role

5. Pilot - December 12 – March 2013 • Targeted 7 day service in Medical Wards and Care Of Elderly Wards • Occupational Therapy staff • Physiotherapy staff • Social Work Staff • funded non recurrently to provide Saturday and • Sunday service Targeted MDT 7 Day Working Pilot

6. Assess and Treat New Referrals on Sat & Sun • Facilitate Discharge over weekend • Continue Therapy treatment programmes over weekend for patients identified for discharge/potential discharge • Increased opportunity to meet families to plan discharge/ organise equipment etc. Role of Multi-disciplinary Team

7. Improved patient experience by providing therapy at weekends • Early intervention and improved outcomes for patients • Proactive service that identifies and facilitates possible weekend discharges. • Increased number of patients ready for discharge on Monday  Benefits (1)

8. Increased capacity to respond to weekend hospital admissions • Capacity to deliver continuous treatment    • MDT communication and decision making available at weekends • Ability to provide equipment on Sat and Sun Benefits (2)

9. Work evenly distributed across week. Staff not fire fighting Monday and Friday. • Improved patients outcomes • Staff very willing to continue with pilot. • Opportunities for increased flexible working compared to Mon- Fri arrangements Feedback from Staff

10. A relative commented that he was glad his mother was not going to have to stay in bed all weekend waiting for the physiotherapist to come and assess and issue her with the appropriate walking aid on Monday. The lady was able to get up and start mobilising over the weekend. Patient Stories

11. A gentleman, who was planned for interim placement on Monday had improved so much with therapy over the weekend that he was able to complete stairs and go directly home rather than going to interim placement Patient Stories

12. A patient with an Acetabular fracture was non weight bearing on Friday and as the Physiotherapist was available over the weekend, the lady was able to get up and begin mobilising on Saturday and Sunday. She was able to be placed in a rehab bed in the community the following Tuesday. Patient Stories

13. Member of staff from Community who has knowledge of Services/Initiatives available in Community • Facilitate Earlier Discharge from Hospital to Community and improve patient flow • Educate hospital staff re Community Alternatives • Knowledge of capacity of community teams • Build Hospital Staff confidence re Community staff skills Role of Community Expeditor

14. Knowledge of Community capacity/ alternatives • Informed and improved Decision Making re Discharge Planning • Champion patient going directly home • Building Links with Community Teams, e.g. Integrated Care Teams, Rapid Response, Reablement • Identify and remove barriers contributing to delays • Hospital staff have improved knowledge and confidence re skills of community staff Benefits of In-reach

15. Staff engagement • Daily Whiteboard meetings • Increased purchase of beds in Community • Single point contact to order equipment required for safe discharge • Joint Social Work post with Belfast Trust • Rapid response clinics pilot in Primary Care • Additional Consultant MAU Additional Initiatives to Improve Patient Flow

16. Waiting time from referral to initial physiotherapy assessment and treatment 93% referrals assessed and treated within 24 hours

17. Summary MDT Activity Saturday and Sunday 500 New Patients assessed and treated Sat and Sun 884 patient contacts Saturday and Sunday

18. OutcomesReduction in Length of Hospital Stay Reduction in average Length of Stay of 2.5 days

19. Outcomes Discharges from Hospital Wards 26% average increase in number of Patients discharged

20. Outcomes - Reduction in Length of Stay in Rehabilitation beds Reduction in average Length of Stay of 10 days

21. Since April 2013 – October 13 • Shared pilot results with Trust staff • Shared pilot results with other Trusts and Commissioners at Regional event • Submitted IPT to Commissioners • Successfully secured funding to restart service from September 2013 • Monitoring and evaluating service each weekend

22. Outcomes: mid September to present • Increased number of discharges at weekends • Ulster Hospital: performance has improved • Identified and removed some barriers to discharge – equipment and pharmacy issues • AHP and SW staff recognised as having key roles to improve patient flow within Trust

23. Improved patient flow essential to • support A&E • Engagement with Multi disciplinary • teams is essential to achieve results • True 7 day working is critical for • success across hospital and community • systems. • Integrated working across both hospital • and community delivers results Conclusion

24. Thank you