Allied Health Professions Day 2021 - Celebrating Our Therapy Teams

ALLIED HEALTH PROFESSIONS DAY 14TH OCTOBER 2021

CELEBRATING OUR THERAPY TEAMS

CELEBRATE | APPRECIATE | INSPIRE | CONNECT

It’s a time to raise awareness of the role Allied Health Professionals play in Healthcare

ADMINISTRATION The Therapy OPD team have supported the delivery of safe and effective services in both inpatients and outpatients across SaTH. During the first wave a significant number of staff were re deployed to support inpatient services working in areas unfamiliar to themselves supporting inpatient therapies.

On returning staff were part of the Outpatient team restoring services and implementing new ways of working. In the 3rd wave staff were proactive in redeployment, many of who had experienced Covid first hand. Staff have worked in unfamiliar clinical areas, upskilled to ensure safe clinical delivery, cancelled leave, changed working days and sites to support patient care.

Staff who remained in the OPD department or who had to work from home increased their caseload to accept patient's form their redeployed colleagues, implemented virtual consultations, changed working practices to ensure Covid secure environments, an ambitious team the department has been at the forefront of SaTH Attend Anywhere delivery, and successfully gained funding and recruited staff to support the Better Births initiative and an early implementer for pelvic health services.

The admin team have been a crucial part and have cancelled and restored clinics, prioritised patients, monitored the backlogs and amended clinic templates whilst implementing Covid screening and virtual platforms on a reduced staffing whilst continuing to support Therapies' critical activities. Covid has brought challenges and a breadth of experiences and the team has adapted and learnt from this, supporting each other throughout.

CARE CLOSE TO HOME Teams within the Therapy Care Closer to Home Centre Inpatient Dietetics and Speech & Language Therapy Team - RSH & PRH Community & Outpatient Speech & Language Therapy Team – RSH & PRH Community & Outpatient Dietetics Team –RSH & PRH Macmillan Integrated Therapy Service – RSH

All our teams have worked incredibly hard, with the greatest possible flexibility, and commitment, to ensure safe delivery of services across inpatient and outpatient areas, whilst supporting provision of Community Dietetics and Speech & Language Therapy Services, helping to keep patients safely at home. Staff rose to the challenge of working differently, undertaking additional training to enable teams to support Critical Care Services on both sites from the beginning of the First wave, and throughout the challenges of the 2nd and 3rd waves, dealing with increasingly complex patients. Our Community staff supported the Acute Hospital Teams, enabling them to focus on the most complex patients in our care, joining their colleagues working on the wards.

Macmillan Therapy Staff have extended support to their general inpatient therapy colleagues, working additional hours to ensure the most effective deployment of our highly specialist resources.

Our Outpatient Teams embraced the challenge of successfully delivering consultations using Attend Anywhere, and have adapted to new working environments, the result of social distancing, whilst flexibly working from home. All our staff have been absolute heroes; supporting one another through the most difficult of times, and our Assistant staff have been phenomenal in helping to maintain our service delivery throughout. Our Team Coordinators have done amazingly, supporting staff with resilience and well-being, helping them to continue to cope with challenges faced at work, and the impact of Lockdown on loved ones.

Throughout all the challenges, they have carried on relentlessly to keep services maintained, truly living our Trust values throughout, I am incredibly proud to work with such a wonderful team! They all deserve to be nominated for the incredible work they have done, and continue to do!

CRITICAL CARE Critical Care Team – PRH As a team, we have been privileged to assist patients back to some normality after prolonged periods of critical illness. COVID-19 has thrown many challenges for us as a team, but having the ability to follow these patients through their journey until discharge has been emotional. We have been a key link between patients’ and their families whilst visiting has been suspended, encouraging interaction through face time, phone calls and through the windows of ITU! Through a time of sadness and uncertainty, there are many positives that we can take forward to continue to develop and provide the best possible care for all of our patients. #RehabLegends

ESD PRH

ESD focussed on maintaining a quality remote service throughout the initial wave of the Pandemic.

Using a comprehensive risk assessment, face to face appointments have been returning. Patient and Staff safety has been paramount.

Staff have adapted to the Attend-Anywhere scheme as this has been introduced to the service.

An enhanced pilot scheme has been run during Covid—It has assisted in growing support for more patients to access our service.

Extending the ‘In Reach’ pilot to Bridgnorth during the pandemic. We have shared our specialist knowledge and skills with the staff at Bridgnorth Hospital.

FRAILTY TEAM

Team PRH As a team we have worked hard throughout the year at the front door to facilitate safe discharges from the emergency department to allow patients to be at home, and improve hospital flow. We assist in preventin hundreds of unnecessary hospital admissions, freeing up beds for acutely unwell patients.

INPATIENT OT The surgical Occupational Therapy Team has increased collaborative working with the community team, resulting in a shared approach to completing access visits. This freed up more time for Occupational Therapists to work with our patients in hospital. We have also explored how technology can be used to give us more information about a patient’s home environment.

Our biggest achievement in the past year was to be able to work as a team to provide patients with the best possible care. This required flexible working, often in areas that we may have been unfamiliar with. We also developed our forms of communication with patient's families and carers to ensure that they felt involved in their relatives care and discharge planning.

Therapists play a major role in the Frailty Intervention Team. As part of this team, an enhanced 7-day therapy service was created at RSH over the Winter of 2020 and has been extended until September 2021 pending a business case. So far, our interventions have avoided 4 admissions each day and we work to ensure that complex frail patients are cared for in the most appropriate setting, often outside of the acute bed base.

Teamwork has been more crucial than ever, with staffing challenges made more significant due to infection control, sickness and re-deployment. Together, we have managed multiple ward areas with staff often working in areas unfamiliar to their normal working practice. We have cross-covered for each other and developed new skills to support aspects of of our working but equally recognising and maintaining our professional identities.

Creation of an End-of-Life Occupational Therapist role to increase the number of patients being discharged to their referred pace at the end of their life, and provide specialist therapy input for this patient group. We are now awaiting the result of a business case to hopefully continue this vital role. We introduced senior therapy management support on the weekend, to ensure that staff had access to a manger to escalate concerns and assist with patient flow 7 days a week. We trialled new ways of working as a team to ensure we reacted quickly to changes in patient flow.

The Management Team, which includes the Team Coordinators and Operational Managers altered working patterns and increased their hours to support the team, both clinically and non-clinically.

They ensured that the team functioned operationally in the day to day response to the changes and challenges faced, while maintaining team health and wellbeing, two of our priorities over the last year.

INPATIENT PT Our biggest achievement in the past year was to be able to work as a team to provide patients with the best possible care.

This required flexible working, often in areas that we may have been unfamiliar with. We also developed our forms of communication with patient's families and carers to ensure that they felt involved in their relatives care and discharge planning.

Therapists play a major role in the Frailty Intervention Team.

As part of this team, an enhanced 7-day therapy service was created at RSH over the Winter of 2020 and has been extended until September 2021 pending a business case. So far, our interventions have avoided 4 admissions each day and we work to ensure that complex frail patients are cared for in the most appropriate setting, often outside of the acute bed base.

Teamwork has been more crucial than ever, with staffing challenges made more significant due to infection control, sickness and re-deployment.

Together, we have managed multiple ward areas with staff often working in areas unfamiliar to their normal working practice. We have cross covered for each other and developed new skills to support aspects of our working but equally recognising and maintaining our professional identities.

Red Team A was created to treat the respiratory needs of the most critically ill Covid-19 patients at RSH, both in intensive care and on the respiratory wards. Despite anxiety surrounding a new virus with unknown impact, physiotherapists from all specialities worked together to cover extended hours over all 7 days. Our proudest achievements and memories over the last 18 months will be knowing that patients were placed at the heart of rehabilitation plans, no matter how difficult the circumstances and environment. Seeing patients overcome critical illness and return home to their families is the greatest reward for the team.

We have received several messages from patients since discharge, thanking us for our input.

Creation of an End-of-Life Occupational Therapist role to increase the number of patients being discharged to their referred pace at the end of their life, and provide specialist therapy input for this patient group. We are now awaiting the result of a business case to hopefully continue this vital role. We introduced senior therapy management support on the weekend, to ensure that staff had access to a manger to escalate concerns and assist with patient flow 7 days a week. We trialled new ways of working as a team to ensure we reacted quickly to changes in patient flow.

The Management Team, which includes the Team Coordinators and Operational Managers, altered working patterns and increased their hours to support the team, both clinically and non-clinically. They ensured that the team functioned operationally in the day to day response to the changes and challenges faced, while maintaining team health and wellbeing, two of our priorities over the last year.

MACMILLAN INTEGRATED THERAPY TEAM

We have continued to provide specialist Speech and Language Therapy, Dietetics, Physiotherapy and Occupational Therapy. We support patients with a cancer diagnosis across SATH and in the community.

We have continued to support our patients adapting our working practices to ensure staff and patient safety. These modifications include clinics being completed via video call and telephone support.

Home visits and face to face support has continued with the appropriate risk assessments completed and PPE worn.

The Macmillan Physiotherapist and Dietitian were made part of the Covid ITU team to spread the skill mix to help across the trust.

The team were joined by a seconded Physiotherapist from the community trust to assist on the Oncology and Haematology ward upskilling him in managing this patient group.

We have continued to support other teams/community staff with more complex cancer patients whenever and wherever this has been needed throughout the pandemic.

We have embraced the use of IT into our daily work to continue providing the support our patient’s needs.

NEURO AND OPD MSK Within Therapy Outpatients at SATH we deliver the following services: • • • • • • • • • •

MSK Outpatient Physiotherapy MSK Hand therapy Neurological Outpatients Pelvic health Inreach to clinics – Virtual fracture clinics, ED, Band 6 Fracture clinic Vestibular Rehabilitation Amputee Rehabilitation Hydrotherapy Injection clinics Spasticity and Complex Disability Service – including botulinum toxin clinics (Inreach, outreach and community) The Therapy OPD team have supported the delivery of safe and effective services in both inpatients and outpatients across SaTH. When Covid hit in March 2020 a large proportion of our staff in OPD needed to be redeployed to the Inpatient team to support the wards. This involved re-training and re-skilling in Respiratory physio and working in very different areas from an outpatient’s environment.

Our team of APPs who usually work in Fracture clinic and ED were redeployed to work in the MIUs in Whitchurch and Bridgnorth, and our APP hand therapist was redeployed to work alongside the upper limb consultants in clinics at RJAH. The staff that remained in the OPD had to continue to provide a service for our most urgent outpatient referrals.

On return from redeployment the staff embraced new ways of working in a covid secure environment using virtual appointments and despite significant challenges around space and equipment achieved a very successful Attend Anywhere roll out, with therapies being one of the top 3 achievers within the trust. Following on from APPS working in MIUs a lot of work has been done to set up further soft tissue injury clinics at both sites.

In the 3rd wave staff were proactive in redeployment, many of whom had experienced Covid first-hand.

Staff have worked in unfamiliar clinical areas, upskilled to ensure safe clinical delivery, cancelled leave and changed working days and sites to support patient care. Staff who remained in the OPD department or who had to work from home, increased their caseload to accept patients from their redeployed colleagues.

Since the most recent redeployment in January 2021 the extensive back log of patients within OPD on waiting lists has increased considerably. There is now ongoing work to try to tackle this within Therapy OPD looking at Group work as Covid allows Extended hours and Saturday clinics.

The team have been extremely flexible, resourceful, patient and have always had a “can do” attitude throughout this pandemic, putting patient centred care at the heart of what we do. Teamwork has shone through, and we have all learnt to work and live in very different ways. An ambitious team the department has been at the forefront of SaTH Attend Anywhere delivery and has successfully gained funding and recruited staff to support the Better Births initiative and an early implementer for pelvic health services.

OUTPATIENTS Within Therapy Outpatients at SATH we deliver the following services: • • • • • • • • • •

MSK Outpatient Physiotherapy MSK Hand therapy Neurological Outpatients Pelvic health Inreach to clinics – Virtual fracture clinics, ED, Band 6 Fracture clinic Vestibular Rehabilitation Amputee Rehabilitation Hydrotherapy Injection clinics Spasticity and Complex Disability Service – including botulinum toxin clinics (Inreach, outreach and community) The Therapy OPD team have supported the delivery of safe and effective services in both inpatients and outpatients across SaTH. When Covid hit in March 2020 a large proportion of our staff in OPD needed to be redeployed to the Inpatient team to support the wards. This involved re-training and re-skilling in Respiratory physio and working in very different areas from an outpatient’s environment.

Our team of APPs who usually work in Fracture clinic and ED were redeployed to work in the MIUs in Whitchurch and Bridgnorth, and our APP hand therapist was redeployed to work alongside the upper limb consultants in clinics at RJAH. The staff that remained in the OPD had to continue to provide a service for our most urgent outpatient referrals.

On return from redeployment the staff embraced new ways of working in a covid secure environment using virtual appointments and despite significant challenges around space and equipment achieved a very successful Attend Anywhere roll out, with therapies being one of the top 3 achievers within the trust. Following on from APPS working in MIUs a lot of work has been done to set up further soft tissue injury clinics at both sites.

In the 3rd wave staff were proactive in redeployment, many of whom had experienced Covid first-hand. Staff have worked in unfamiliar clinical areas, upskilled to ensure safe clinical delivery, cancelled leave and changed working days and sites to support patient care. Staff who remained in the OPD department or who had to work from home, increased their caseload to accept patients from their redeployed colleagues.

Since the most recent redeployment in January 2021 the extensive back log of patients within OPD on waiting lists has increased considerably.

There is now ongoing work to try to tackle this within Therapy OPD looking at Group work as Covid allows Extended hours and Saturday clinics.

The team have been extremely flexible, resourceful, patient and have always had a “can do” attitude throughout this pandemic, putting patient centred care at the heart of what we do. Teamwork has shone through, and we have all learnt to work and live in very different ways. An ambitious team the department has been at the forefront of SaTH Attend Anywhere delivery and has successfully gained funding and recruited staff to support the Better Births initiative and an early implementer for pelvic health services.