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‘This isn’t a threat – it’s an opportunity for revolutionary change’

Writing for HT World, Brian O’Shea, continuing healthcare advisor at the Spinal Injuries Association, urges commissioners to embrace change for the good of the patient.

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As a service user and patient advocate, I believe it’s important to always consider the patient perspective of going through the NHS Continuing Healthcare (CHC) process.

I think it’s important to recognise that when people encounter the CHC or local authority assessment process, it is more often than not the first time that they’ve engaged with the health and social care system.

This usually results in an overwhelming experience for patients, or their carers, as they have so many questions about the process.

It can therefore appear to CCG or CHC advisors that patient questions don’t really arise in a logical flow or sequence. They will often ask questions as they emerge in their minds, for example, “How does this thing work and how can I make sure my voice is heard?

What’s happened so far in the process? What happens next?” However, the most frequently asked question about the process is, “Who can I speak to?”

Brian O’Shea

It is really important to think of this experience not only from the individual patient’s perspective but also from anyone who is working with them to get through it, whether that is an advocacy organisation such as SIA or simply an interested relative.

Quite often when a patient or their relative contacts us, we start to ask them what we think are simple questions: Where are you? Have you had a check list done?

Have you had a referral made? However, as it is often their first experience dealing with the health and social care system, they just don’t know the answers.

Using a patient portal

Previous NHS CHC improvement initiatives have focused on answering this question by allocating a case worker to take individuals through the end-to-end NHS CHC process.

However, we know that this falls down because the individuals managing the process leave the NHS organisation handling the individual’s application, or there is a change in the contact details of the CCG etc.

And there are many more factors and variables that can disrupt the communications between the individual and the CCG, leaving the individual in the maze or even worse, just in the void.

And so, I think digitisation in this area of healthcare delivery is tremendously exciting.

I think that, through the trials of the last year, we have seen how empowering the move over to digitisation can be across the whole of the health and social care sector – when it is done properly.

In this spirit I see a patient portal as a potential solution to many of the questions the CHC process brings up for both patients and CCGs.

We once asked as an industry, “How do you address the issue of having a dedicated individual to take the patient through the assessment and care plan process from end-to-end?”

Well, the answer may just be that you don’t actually need an individual to take the patient through the process, maybe that can be achieved by a digital platform.

There is also a growing awareness amongst patients of the amount of personal information the NHS holds.

I think that one of the advantages of the patient portal on the digital platform, particularly demonstrated in the Digital CHC by IEG4, is that the CCG can make the data more transparent to patients and families.

Sharing the assessment information and the discussions from the MDT meeting builds trust in the process and ensures that patients and families are at the heart of the CHC decisions.

However, having a patient portal is not necessarily throwing open the doors and having absolutely no control of the information between the patient and the heart of the NHS. It is more about understanding the information that an individual needs to generate trust in the NHS CHC assessment process.

As advocates we recognise that, for some patients, if you gave them access to everything it could be just as overwhelming as not giving access to any information. So, it is important for the CCG to build flexibility into their digital platform and strike the appropriate balance for each individual patient.

An additional advantage with a digital platform, is that you don’t have to wait for 9-5 office hours to get an answer to your questions, you can access the information yourself at a time to suit you.

The platform can answer the questions of who has already been involved and who is going to be involved, what the next steps are, and it can also keep track of what’s already been done. No chasing telephone calls taking up time of health and care professionals and an ability for patients and family members to take control.

The Future’s bright, the future’s digital

The path to the digitisation of healthcare services has not been straight forward, and there is still some work to be done in ensuring that safety sits atop the agendas of CCGs when it comes to its adoption, however seeing how platforms like IEG4 take steps to improve this is encouraging.

Both as a patient and as a patient advocate, I cannot tell you how excited I am about the move to digitisation of Continuing Healthcare.

I honestly think it has the potential to be revolutionary.  I think that when used appropriately by CCGs it could be a revolutionary step forward in the quality of decisions made, in the amount of time that it takes to make decisions and it has the potential to be revolutionary for the individual patient experience of the NHS CHC assessment process.

I would really encourage CCGs and local authorities not to see it as a threat. To me it is just such a great opportunity and I think it is really pivotal in changing how we engage with Continuing Healthcare.

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QEF’s accessible technology wins international awards

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The new Care and Rehabilitation Centre in Surrey, developed by Queen Elizabeth’s Foundation for Disabled People (QEF), has won 2 international CEDIA awards for its innovative use of accessible technology, which was supplied by technology solutions partner Imperium Building Systems Ltd.

These awards recognise the improvement technology can make to the lives of disabled people, which is reflected at a UN event that forms part of this year’s International Day for People with Disabilities. The global UN awareness day today (December 3) highlights the challenges and discrimination disabled people face around the world, and pushes for positive change towards greater inclusion, accessibility and equality for disabled people.

This year on December 3, the UN is co-hosting an event specifically looking at ‘Reducing Inequalities through Technologies’ noting that: ‘persons with physical, sensory, cognitive/learning or invisible disabilities represent nearly 15 per cent of the world population’ 1 and that ‘for some kinds of disabilities, assistive devices/technologies are key “equalizers” that promote inclusion and full participation in all industries and dimensions of life’. 1

The event also highlights that ‘One billion persons with some form of disability can benefit from assistive technologies that can facilitate their social, economic and political engagement, including their participation in decision-making processes that affect their lives and ambitions’ 1

QEF’s Care and Rehabilitation Centre provides neuro rehabilitation for people after an acquired brain injury, stroke, incomplete spinal injury or other neurological condition and clients are supported by expert staff to relearn core skills, so they can rebuild their lives and be as independent as possible.

QEF’s vision for the new Care and Rehabilitation Centre was to use technology to give each person greater control over their personal space, no matter what a person’s impairment may be. It’s easy to take for granted being able to close the blinds when the sun is in your eyes or turn the lights off when you want to go to sleep – until you can’t do it for yourself. QEF wanted a system that empowered clients to have a greater sense of self-determination and influence over everyday activities during their rehabilitation.

Imperium developed the project with QEF, producing a cost-effective ‘smart home’ solution, using easily available technology that is adaptable to each persons’ specific requirements. Five connected smart devices have been installed in each bedroom which can be controlled in different ways; either with standard voice commands, pre-programmed accessible switches or programmable text to talk commands.

Ann, a client at QEF’s Care and Rehabilitation Centre, says: “I wasn’t sure about it at first – it was odd to sit in my room on my own and talk to something, but now I use it all the time. You can have the blinds down, lights on or off or the TV on or off. It’s another step on the journey of independence, so I don’t have to ask someone to do it for me.”

Chris Thorne, director of Imperium, says: “The technology we have installed for QEF will allow service users to have control over the lights in their room, temperature, day light via shading blinds, and audio-visual equipment. So, someone could stay in one position and manage their entire room, either with switches or voice controls. It also needed to be technology that service users could easily access after they left the service; creating independence that could continue beyond QEF’s walls.”

The international CEDIA awards recognise technical excellence and product innovation in the home technology industry. Imperium’s project with QEF was announced in November 2021 as winners in the ‘Multi Dwelling Unit Design’ category and also went on to win the overall award for ‘Life Lived Best at Home’ which reflects the project that gives the best experience for a client.

Judges for the Life Lived Better at Home award said: “This entry is outstanding for its sensitive and pragmatic response to the brief and for the way the technology meets the changing needs of the users. And all this achieved on an extraordinarily tight budget. I hope there will be many more projects like this in the future!”

Karen Deacon, QEF’s chief executive, says: “Our new Care and Rehabilitation Centre gave us an opportunity to use technology in an innovative way that would directly benefit clients as they relearn core skills. Adapting to life after an acquired brain injury is challenging for anyone and if technology can help give someone back their sense of control over everyday activities then we wanted to be able to offer that as part of our neuro rehabilitation programme.”

  1. Reducing Inequalities Through Technologies: A Perspective on Disability Inclusive Development https://www.un.org/development/desa/disabilities/wp-content/uploads/sites/15/2021/11/IDPD2021ConceptNote.pdf

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Webinar to explore the future of brain injury rehab

Join our panel of expert guests as we discuss the challenges and opportunities in improving patients’ lives

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The future of brain injury rehabilitation and how patients can be supported in new ways is to be examined by leading experts from across the sector at an event held next week. 

Brain injury rehab has made huge strides over the years, innovating and developing to better meet the needs of people living with life-changing injuries. 

Through changes in technology, developments in medicine and the advances in neurorehabilitation, brain injury patients should face an outlook which is better than ever before. 

However, the lack of resource within health services, exacerbated by the ongoing impact of COVID-19 and mounting pressures on the NHS, mean that progress and change is not being seen at the rate many would hope for.  

In 2020, the British Society of Rehabilitation Medicine (BSRM) identified the increased pressure on neurorehabilitation, highlighting the “unquantifiable additional case-load of patients with post-Covid disability presenting with a wide range of problems due to cardio-pulmonary, musculoskeletal, neurological and psychological/ psychiatric complications of the disease.”

In an upcoming webinar – What does the future of brain injury rehabilitation look like? – to be held on Wednesday next week (December 8th) and organised by NRC Medical Experts in association with NR Times, this matter will be examined to assess the scale of the challenge, the opportunities that exist, and what more can be done to better support patients. 

The panel will comprise:

The live hour-long event, from 4.30pm to 5.30pm, will include a panel debate, with questions welcomed from the audience. 

“Health and social care services have been under increasing pressure from an ageing population for decades and this has now been exacerbated by the disruption created by COVID-19,” says Edmund. 

“Brain injury rehabilitation services have always been poorly resourced in the UK, and are now under increased strain while professionals are diverted into the acute management and rehabilitation of COVID-19 patients. 

“It is essential therefore that we consider how to improve service delivery models so that people with brain injury do not fall further behind in the queue. 

“Technological innovation in its many forms offers much potential here, but realising this will be a substantial undertaking for which we are as yet ill-prepared. 

“During this webinar we will explore some of the major opportunities and problems.”

To attend the webinar, registration is required in advance. To sign up, visit here 

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Thousands supported by communication training

In its first year, the Communication Access project has engaged over 4,500 organisations and individuals

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Thousands of organisations and individuals across the UK have benefitted from an initiative to support people with communication difficulties since its launch a year ago. 

The Communication Access UK scheme, a free e-learning tool, delivers training on accessible face-to-face, telephone and online conversation and customer service, in support of the millions of people in the UK who live with some form of speech, language or communication disability. 

Organisations that complete the training will be able to display the Communication Access Symbol in their workplace, demonstrating their commitment to supporting customers and staff who experience difficulties in communication. 

More than 4,500 businesses, organisations and individuals have already taken part in the initiative, which launched last November and was developed by the Royal College of Speech and Language Therapists (RCSLT), in partnership with the Stroke Association, Headway, MND Association, Business Disability Forum, Communication Matters, The Makaton Charity, and the National Network of Parent Carer Forums.

And on the first anniversary of its launch, two organisations have achieved landmark ‘firsts’ in support of Communication Access. 

Barnsley FC has become the first football club in the UK to undertake Communication Access training and commit to supporting people with speech, language and communication barrier. Its charity arm, Reds in the Community, has also signed up to the initiative.

Northern Devon Healthcare NHS Trust (NDHT) has also become the first NHS Trust in England to gain accreditation to the standard, offering the package to its entire workforce. 

The success of the scheme to date comes as the campaign to secure better access to speech and language therapy continues, with thousands supporting a petition to the Government and 20 APPGs calling on Prime Minister Boris Johnson for action.

“Communication disability in the UK affects millions of people, so I’ve been thrilled to see so many organisations and individuals register for the free multi-award winning Communication Access training in the last year,” says Royal College of Speech and Language Therapists’ chief executive, Kamini Gadhok.

“Barnsley Football Club has just become the first football club to be CAUK accredited, while North Devon Healthcare NHS Trust is the first NHS Trust to commit to training its entire workforce to enable them to provide communication accessible services and it’s been fabulous to see organisations setting the bar for others in this way.

“Of course, we’d like to see many more businesses and people register for the training, so please visit the website and register for the training today.”

Barnsley FC’s CEO, Khaled El-Ahmad, said: “Our club has a number of touchpoints, both of digital and physical nature, and it is integral that we provide the best service possible to supporters. 

“Knowing that we are making strides to communicate in an inclusive manner is positive, as we look to improve our offering and overall experience for individuals living with disabilities at Oakwell.”

Andrea Bell, deputy chief nurse at NDHT, added: “At NDHT, we encounter a huge variety of patients with extra communication needs, from those who may have had a stroke to people with visual or hearing impairments. It’s vital that we are able to communicate with them to give them the best possible care.

“We’re extremely proud to be the first Trust in England to become part of Communication Access, and we hope other Trusts will follow our lead in facilitating the best possible communication with patients.”

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