Interesting report on PT and Older People in the UK from the NHS Audit
Commission.
http://www.audit-commission.gov.uk/ac2/NRfirst.htm
The Way to Go Home
Rehabilitation and Remedial Services for Older People
Older people are major users of health and social services.
two-thirds of hospital beds are occupied by people aged
65 or over
two-thirds of social services expenditure on people over
75 goes on residential and nursing home care
the numbers of older people are growing, increasing
pressures on these services
Effective rehabilitation can help people to stay at home, or
return home, after hospital and reduce admissions to residential
and nursing homes. It requires a range of services…
multidisciplinary teams working in people's own homes to
prevent admissions and help people home after hospital
after acute care, further specialist medical and nursing
attention as part of an intensive multidisciplinary
programme
once medical problems have stabilised, places in homely
settings for more active rehabilitation and confidence
building
…and well-integrated care.
processes and services should be clearly linked
care should be co-ordinated by a multidisciplinary team
within the framework of a multi-agency joint investment
plan
In practice, services are variable…
in areas visited, the number of rehabilitation beds per
person over 75 varied by a factor of five
therapy time per bed varied from a few minutes to nearly
one hour per day
…and there are major gaps.
only one-third of areas have multidisciplinary teams to
support people at home, reducing hospital emergency
admissions, re-admissions and length of stay
only one-half of trusts have a stroke unit despite strong
evidence of their effectiveness
just one-half of areas have places away from hospitals for
active rehabilitation costing half as much as hospitals
The rehabilitation programme needs co-ordinating…
comprehensive assessment is essential, but under
one-quarter of areas use joint health and social services
documentation
over one-quarter of stroke patients reported poor
communication
out of 15 areas, 2 used combined notes and only 1 a
single care plan
…and therapists need to be used effectively.
good information is required to help managers deploy
therapists to where they are most needed
workforce planning is needed to provide more staff
assistants and helpers can release professionals to work
more effectively
Agencies need to plan together, sharing a 'whole-systems'
approach and making use of new financial flexibilities. Effective
rehabilitation services promote the well-being of older people
and help to reduce waiting lists and winter pressures.
If you want to know more:
Audit Commission, The Way to Go Home
Rehabilitation and Remedial Services for Older People
(National Report)
ISBN 1 86240 221 3
£20.00
This is available as a full summary with diagrams...
...and as a full National Report, both for download as
Acrobat files. [Acrobat Reader V4] The full report is a
large file (2,547Kb).
Copies of this report are available from:
Audit Commission Publications
Bookpoint Ltd
39 Milton Park
Abingdon OX14 4TD
Freephone: 0800 502030
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Douglas M. White, PT, OCS
Physical Therapist, Consultant
191 Blue Hills Parkway
Milton, MA USA 02186
P: 617.696.1974
[log in to unmask]
http://members.tripod.com/DouglasWhite/
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