One of UKABIF’s primary aims is to improve services for people with ABI in the UK. We aim to inform policy makers about ABI and the requirements in terms of care provision.
Please see the following site for further details:
The National Leadership Group report from Amanda Swain, Policy Lead
Amanda Swain attended the NLG meeting on 21st January with feedback from UKABIF on how community services should be delivered. She was able to report with “evidence” that the focus on Acute services with outpatient coding, was not how ‘we’ wanted ABI services. The current focus is on altering coding for Acute service contracts to include more outpatient follow up (with payment) based in 15 national centres. This leaves a big hole for ABI clients to fall through with little appropriate support. The compromise agreed is that community specialised teams use the expert neurologists at MDT telemedicine reviews. Of course the stumbling block is funding; is funding from two budgets or do the CCG’s pick it up?
Amanda has asked that the group reference the recommendations of the 2001 Health Select Committee Report and recommendations for Head injury, the ACC New Zealand 2006 TBI services guidelines and the DOH’s own Better Metrics 7 & 8. (She was dismayed that these 3 referenced documents were not known to many of those around the table) The Neurological Alliance added the National Service Framework.
Amanda urged the ABN to not write a blueprint for specialised neuro services by themselves but instead to use those of the other colleges such as COT and CSP. The Chair supported the ABN using the other colleges for conditions, not professions.
To influence this proposal, please contact the Neurological Alliance to suggest who you recommend the ABN work with to write a specification for neurological services. Our suggestion is that the document mentions MDT and links to rehabilitation and at least gives a nod to community support. To do this, services have to have an obligation to know the local options. Therefore, the other professional colleges should be invited to contribute.
Clinical Senates – update from Amanda Swain, Policy Lead
Amanda Swain is now on the East of England Clinical Senate whose role it is to advise the Commissioning groups.
Her first task is a proactive initiative to identify:
the top system priorities in the East of England that could / should be addressed by Clinical Senate within the next year and explain their rationale for inclusion and ranking and the most important bodies / organisations/ individuals that Senate Council should be actively engaging with / influencing (these can be national, regional or local), explaining why they are important, and how Senate Council should engage with them
Amanda will be attending the Westminster Health Forum conference: Clinical Senates and Networks, and the next steps for specialised commissioning on behalf of UKABIF on 25th February
The Clinical Reference Group – update from Prof Mike Barnes
This group meets quarterly with the NHS England commissioners. The main focus of discussion is on the UKROC database and the determination of Level 1 and 2 units for specialised rehabilitation across England. There are now fifteen Level 1 rehabilitation centres across England, with 5 being in London. However, some of these centres are currently being reviewed and some may be “demoted” to Level 2 centres in the near future. This is of some concern as just ten Level 1 centres will clearly not be adequate for the needs of those with complex neurological disabilities requiring specialised rehabilitation. There are few more centres, mainly in the independent sector, who have been collecting UKROC data and are now at Level 1 standard. However, of further concern is that at that moment no more centres are being “officially” recognised by NHS England. The Local Area Team can contract with any centre but is much less likely to do so if the centre is not designated in the UKROC scheme. Once again a source of concern as the number of beds in Level 1 units is inadequate for the current needs of this group of people. Indeed many trauma units are now having difficulty in discharging people to appropriate centres, which effectively blocks a bed for another patient in need of the trauma service.
The final complication is that NHS England has run out of money for specialised commissioning in this financial year and many Area Teams are simply not able to afford to buy any service at all! This is all very unfortunate. We are in the situation where the need is clear and the service is available but is not being purchased. More lobbying is required!
Health and Social Care Bill
The Health and Social Care Bill proposes to create an independent NHS Board, promote patient choice, and to reduce NHS administration costs.
establishes an independent NHS Board to allocate resources and provide commissioning guidance
increases GPs’ powers to commission services on behalf of their patients
strengthens the role of the Care Quality Commission
develops Monitor, the body that currently regulates NHS foundation trusts, into an economic regulator to oversee aspects of access and competition in the NHS
cuts the number of health bodies to help meet the Government’s commitment to cut NHS administration costs by a third, including abolishing Primary Care
Trusts and Strategic Health Authorities.
UKABIF have provided feedback to the proposed changes to the Bill through the Neurological Alliance, National Voices and the Future Forum. UKABIF has also made a direct response to the proposed changes to the Bill.
Our key issues are that:
1. Neurology should be represented on each clinical senate
2. Neurological pathways should be funded and embedded throughout the NHS
You can view UKABIF’s full response by clicking here.
IBIA published articles list
The International Brain Injury Association produce a list of recently published articles which can be accessed by following this link.