Insights into South East London Neuro Navigation Service (SELNNS)
Explore the unique experience and core roles of Occupational Therapists in the SELNNS, part of Guys and St. Thomas NHS Foundation Trust. Discover how they navigate neurorehabilitation services and provide crucial support to patients and their families in South East London.
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The experience of OTs working in the South East London Neuro Navigation Service (SELNNS) Jodie Carolan & Majella Brennan 4th August, 2019
Overview South East London Neuro Navigation Service (SELNNS) and its inception Occupational Therapists (OTs) perfectly placed for Neuro Navigation Reflections on a non-traditional role
South East London Neuro Navigation Service SELNNS Part of Guys and St Thomas NHS Foundation Trust One of five teams under community neurorehabilitation services Started as Pilot Program in 2015 within Southwark and Lambeth Expanded in 2016 to cover the six South East London boroughs (Bexley, Bromley, Greenwich and Lewisham) Made Business as usual in 2018 Team of 7 currently comprised of OTs and physios with extensive background in neurorehabilitation
Core Roles of Neuro Navigation To ensure patients are referred to the most appropriate service to meet their neurorehabilitation needs Do they need specialist inpatient neurorehabilitation? Can their needs be met via non-specialist provision/alternative care pathways? e.g. community provision, specialist nursing home What services are available in their local area? To facilitate earlier transfer of patients with specialist neurorehab needs from acute hospital to rehabilitation services Early referral to neurorehabilitation services Avoid inappropriate referrals Redirect referrals as patients needs change Work with specialist neuro rehabilitation units to facilitate timely discharge
Core Roles of Neuro Navigation To provide continuity of contact for patients and their families through the complex neuro rehabilitation pathway Repatriation through tertiary to local hospitals Inpatient and community neurorehabilitation services To provide an educational role within the local health services to advise clinicians on appropriate neuro rehabilitation pathways To provide expert knowledge on local neurological rehabilitation service provision (demand and gaps in services) to contribute to future commissioning decisions
Role Variance All London Neuro Navigators have the same core roles Some Neuro Navigators have ADDITIONAL roles Continuing Healthcare Assessments & Specialist Placements Clinical Leads within a therapy team Referral and triage point for community neuro rehab teams SELNNS is a unique model of team working across 6 boroughs Other London Neuro Navigators cover a single borough
What do we actually do? Patient-specific Attend weekly MDMs; goal planning / family / discharge meetings; referral & assessment meetings; Rehab Consultant rounds Specialist assessment of rehab needs; joint sessions with treating teams Over 50 services we work with regularly 6 hospitals in SEL + others 10+ specialist inpatient neurorehab services (incl. Spinal units) Neuro and non-neuro community rehab services Outpatient services / clinics / programmes incl. vocational rehabilitation Social services Voluntary / charity
What do we actually do? Education Rolling program and bespoke education sessions with treating teams Neuro Navigator role; structure of specialist neurorehab services; community rehabilitation; local services & resources Hospital engagement and escalation Platinum / MADE events & senior bed management meetings Ward level feedback Engagement with commissioning Regular formal & informal meetings with our commissioners Formal Service KPI reporting SELNNS Service Evaluation & Gap Analysis
What do we actually do? Active in strategic networks Chair of the Pan-London Neuro Navigation Network NHSE Specialised Commissioning Neurosciences Networks King s Health Partners South London Operational Delivery Network Clinical Networks South London Stroke Network; SELKaM Trauma Network SELNNS & Neurorehabilitation promotion Conferences various stalls and speakers Headfirst, European Neuro Convention, Chief AHP Officer s Conference, Complex Neuro Conditions conference, ABIL, UKABIF Upcoming audience with MP - to raise awareness of ABI
What do we actually do? Successes / Achievements Demonstrated significant cost savings by avoiding admissions and reducing length of stay in hospitals and specialist units estimated over 2 million in our first year (2016 / 2017) HSJ Value Award Shortlisted in 2018 NICE Scholarship awarded to Bexley Neuro Navigator 2018 / 2019 Neurorehabilitation agenda in SEL: Raised awareness of gaps in neurorehab pathway to Commissioners Contributed to STP commissioning priority for core offer of community neurorehab service & neuro-psychology provision across the 6 boroughs Part of ongoing SEL Working Party with Commissioners & Providers
Occupational Therapists as Neuro Navigatiors Neuro Navigation is an emerging Allied Health Professions role Provide specialist advice, assessments, advocacy, education and training OT s unique set of skills make us ideally placed to undertake this role. Working within this role you need to be able: To prioritise and work independently High level problem solving skills Excellent organisational skills Evidence of leadership skills Ability to facilitate learning in others Drive and enthusiasm for clinical excellence using EBP and clinical networks
What makes us unique? OT s are dual trained (Mental and Physical Health) Are expertly placed to consider the patient holistically - physical, mental, psychological, social and environmental needs of a patient Have an ability to manage conflict and deal with emotionally challenging situations Effectively communicate with service users with complex communication, cognitive / behavioural or emotional problems Provide practical support to empower people to facilitate recovery- Bridges Self Management approach Advice on practical and purpose-full activities that allow people to live independently and achieve a sense of identity
OTs ideally placed for Neuro Navigation Ability to build relationships within the interdisciplinary team and across organisations to help identify the patients needs. Undertake in-depth assessments of service users with complex physical / neurological disabilities Expert investigative and analytical clinical reasoning skills Recommend an integrated health/social care plan from a range of options available based on assessment findings Work collaboratively with colleagues and have the ability to negotiate, persuade and influence others to maximise outcomes for patients; e.g CCG s, LA s, Treating team s, Commissioners
Able to work harmoniously with a diverse workforce and to deliver a quality service to people from different backgrounds Highly specialised, in-depth knowledge of issues pertinent to people with complex physical / neurological disabilities Up to date knowledge of current practice and research developments within this specialist field Highly developed understanding of the roles of all professions involved in working with this group of service users Understands clinical governance/quality issues around patient- centred care
Reflections Involvement at a strategic level Identification of commissioning priorities for Neurorehab Services Engagement and Lobbying of Parliament Strong focus of professional identity within Organisation Personal commitment to the profession - @theRCOT Engagement with Specialist Section - Joining the Brain Injury Forum
Questions? Contact Details: Jodie Carolan: j.carolan@nhs.net Majella Brennan: majella.brennan@nhs.net T: @brennan_majella SELNNS Email: gst-tr.SELNeuroNavigationService@nhs.net London Neuro Navigator contact list available to download: https://www.networks.nhs.uk/nhs-networks/neuro-navigators-group
