OVERVIEW OF PCT PROVIDER SERVICES

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OVERVIEW OF PCT PROVIDER SERVICES ALLIED HEALTH
PROFESSIONALS/ THERAPY SERVICES Lorraine
Watson Associate Director, Adult Services 19
November 2007
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• THERAPY SERVICES
• Occupational Therapy.
• Physiotherapy/Orthopaedic Triage Service.
• Podiatry/Podiatric Surgery.
• Speech Language Therapy.

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• SERVICE PRIORITIES/KEY DRIVERS
• Impact of and opportunities from Ara Darzi work.
• National targets 18 weeks wait/electronic
  Choose and Book.
• Childrens Trust arrangements.
• Restructuring of Therapy Service Heads post
  create Strategic Leads Children and Adults.
• Practice Based Commissioning.
• National IT system SystmOne/mobile
  technology.
• Service redesign/skill mix/Generic Support
  Workers.

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• OCCUPATIONAL THERAPY SERVICES
• Aim to enable and empower people to maximise
  their potential to engage in meaningful and
  productive activities.
• Range of Community Occupational Therapy Services
  for Adults and Childrens including
• Rehabilitation for Long Term Conditions.
• Vocational rehabilitation.
• Holistic assessment and treatment of physical
  and psychological problems.
• Assessments of personal care and daily
  activities of living.
• Provision of equipment and wheelchairs.
• Adaptations to homes and/or rehousing.
• Assessments for education and social inclusion.

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OCCUPATIONAL THERAPY SERVICES continued Head
of Service Lynn Keirs Staffing
establishment 59.68 WTE Budget 836,600Join
t service with Local Authority 50/50 funding
arrangement.
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OCCUPATIONAL THERAPY SERVICES continued

• Successes
• One OT service across the Health and Social Care
  Community.
• Effective working relationships/ partnership
  arrangements.
• Good reputation regionally and nationally good
  recruitment and retention.
• Extensive skill mix Clinical Specialists and
  Generic Support Workers.
• Timely intervention/fast response to priority
  cases.

• Challenges
• Childrens Trust arrangements staff changes.
• Effective recording of activity multiple
  systems/processes incompatible client databases.
• Demand exceeds supply in some areas long
  waiting lists.
• Implementation of Local Authority review of OT
  services/ Intermediate Care joint commissioning
  agenda.
• Provision of equipment/assistive technology in
  the community.

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• PHYSIOTHERAPY SERVICES
• Aim to help patients overcome pain/functional
  problems to enable them to continue
  working/living in the setting of their choice and
  be as independent as possible, including
• Children and Adults service.
• Musculoskeletal clinic service
  GPs/Doncaster Gate/Health Centres.
• Domiciliary services in clients own home.
• Intermediate Care Community Rehabilitation
  Team.
• Nursing/residential.
• PLD/Mental Health.

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PHYSIOTHERAPY SERVICES continued Acting Head
of Service Paul Chapman Staffing
establishment 53.21 WTE Budget 1,222,846
Includes Orthopaedic Triage service.
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PHYSIOTHERAPY SERVICES - continued

• Challenges
• Redesign of services to address waiting
  times transfer of resources.
• 18 week wait target and electronic Choose
  and Book.
• Practice Based Commissioning GP
  practice requirements.
• High reference costs for service.
• Need to work across boundaries/ MDT
  Intermediate Care/ Childrens Trust.

• Successes
• Orthopaedic Triage service reduction in
  referrals to Secondary Care.
• Review by Meridian non-recurrent funding
  to reduce waiting times.
• Clinical Specialists first therapy
  non-medical prescriber.
• Provided close to home in local
  communities across Rotherham.

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• PODIATRY
• Aim provision of assessment, diagnosis and
  treatment of lower limb pathology, specifically
  the foot and ankle, including
• Annual assessment for key medical groups.
• Lower limb biomechanics and orthoses
  prescription.
• Nail surgery.
• At risk patient management with Palliative
  Care.
• Surgical assessment diagnosis and invasive
  surgery of foot and ankle pathology.

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PODIATRY continued Head of Service Adrian
Conn Staffing establishment 23.90
WTE Budget 845,663 Podiatric Surgery Gary
Boon

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PODIATRY continued

• Successes
• Successful redesign of service provision
  prioritise need/local delivery.
• Short waiting times all less than 6
  weeks/rapid access to care.
• Implementation of Podiatric Surgery
  expansion to 4 days a week.
• Sub-specialities of biomechanics, high
  risk Diabetes and health promotion for
  foot care.

• Challenges
• 18 week wait and electronic Choose and
  Book.
• Compliance with decontamination
  regulations central sterilisation.
• Historical expectations from
  clients/users.
• Further development of clinical specialism.

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• SPEECH LANGUAGE THERAPY
• Aim provide assessment, treatment, advice and
  training service for a range of adult and child
  communication and feeding/swallowing problems,
  including
• Out-patient services voice, stammer, head
  and neck cancer.
• Children speech and language
  delay/disorders, non-fluency, language
  impairment mainstream and special
  schools/CDC.
• Older people dysphagia, stroke, neurological
  disorders, cancers.
• Learning Disabilities swallowing/feeding
  problems, communication.

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SPEECH LANGUAGE THERAPY continued Head of
Service Susan Dent Staffing establishment 25.1
9 WTE Budget 696,279 SLA to provide
services for Rotherham Foundation Trust and RMBC
Education.
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SPEECH LANGUAGE THERAPY continued

• Challenges
• Incompatible IT systems PCT/ LA/RFT.
• Short-term external funding of some posts
  eg, Surestart.
• Childrens Trust staff changes/ redesign
  of service.
• Enhancement of skill mix use of
  Assistants/Clerical support.

• Successes
• Joint working practices/MDT across
  organisations.
• Childrens services Surestart/
  Childrens Centres/LEA in schools.
• Establishment of new services video
  fluroscopy/rapid access for dysphagia.
• Use of triage to give rapid access to
  appropriate specialist.