Petition Reinstate Samares Ward to its full complement of 28 beds and previous services.

The rehabilitation ward has been reduced from 28 beds to just 12 beds and the services offered greatly reduced. This is not in line with the National Clinical Guidelines for stroke rehabilitation. Ensure that the new hospital reinstates the full services within it which we previously had in place.

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According to the data from the National Clinical Guidelines for stroke rehabilitation, Jersey can expect a minimum of 250 people presenting with stroke symptoms each year, this is without taking into account the patients who have head trauma, prosthetic limbs or any other type of trauma which requires extended care. Our HCS management have reduced our bed numbers and the care package given by way of physiotherapy, occupational therapy, speech therapy, dieticians etc to an unacceptable level.

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Ministers responded

This response was given on 6 December 2021

Health and Community Services continues to provide a flexible and comprehensive stroke rehabilitation approach – one that is responsive to individual clinical need and good practice guidance.

Rehabilitation services have not been reduced but are being delivered in different settings and in a number of different ways in line with National Clinical Guidelines for rehabilitation.
In relation to stroke rehabilitation, we continue to maintain sufficient inpatient services. It should be recognised that not all stroke patients require inpatient rehabilitation. The emphasis in most modern well-resourced healthcare systems is to provide inpatient care during the acute phase of rehabilitation which follows as soon as possible after a stroke has occurred. After the acute phase, ongoing rehabilitation and continuing support is usually delivered in the patient’s home or a community setting. This model of treatment delivers better outcomes and patient experience.
However, some patients will still require rehabilitation and support in an inpatient setting after completing the acute phase of treatment. This was previously delivered in Samares Ward and is now being delivered in Plemont Ward. HCS is arranging to extend the inpatient rehab therapy service to the community. This will support timely discharges for islanders from Plemont Ward with support from the therapy team who work there. It will support the continuation of rehabilitation within a patient’s own environment at the earliest opportunity and provide a more seamless handover to the community team. By putting this service in place, HCS aims to enhance a patient’s discharge support, recognising it can be unsettling when transitioning through services.
Samares Ward was close to many people’s hearts in the care and treatment that was provided. However, HCS would like to reassure islanders that the same professional team transitioned with the move to Plemont Ward. There are 14 beds dedicated to rehabilitation with four of those being in cubicles. These beds are flexed according to the number of neurological and stroke patients that are on the unit at any one time. However, rehabilitation is not just confined to Plemont Ward; if a patient on another ward requires rehabilitation, it can be provided within that setting.
HCS recognises that this has made some people anxious about the changes that are currently occurring. It acknowledges that Samares Ward was a spacious, calm, healing environment where patients each had their own room. However, HCS is committed to improving Plemont Ward’s environment to ensure a better experience for patients.
HCS is committed to providing the best care it can give to patients and retaining their confidence. To that end, HCS will be commissioning a report from an expert in rehabilitation services to review existing provision and advise upon the future direction and resource requirements of services locally.
HCS will continue to listen to patients’ views and consult with local charities working with stroke patients and other patients using rehabilitation services. It is currently looking to recruit a consultant in stroke medicine and a consultant in frailty which will enhance the rehabilitation provision further.
In Jersey, the number of persons diagnosed with a stroke is between 100 and 140 people annually. Jersey reports into the Sentinel Stroke National Audit Programme (SSNAP) and collects data on key multi-disciplinary indicators relating to stroke service provision. The SSNAP is a major national healthcare quality improvement programme based in the School of Population Health and Environmental Studies at King’s College London. SSNAP measures the quality and organisation of stroke care in the NHS and is the single source of stroke data in England.
In accordance with the national stroke guidelines, the offer of rehabilitation is initially at least 45 minutes of each relevant stroke rehabilitation therapy for a minimum of five days per week to people who can participate, and where functional goals can be achieved. If more rehabilitation is needed at a later stage, the intensity of the rehabilitation is tailored to the person’s needs at that time. The therapy provision for stroke rehabilitation in Jersey is delivered by physiotherapy, occupational therapy, speech and language therapy and dietetics. There has been no reduction in the staffing numbers for any of these therapy provisions when comparing Samares Ward with the current provision, and no reduction in the package of care offered.
HCS will continue to monitor outcomes following the change in location of the rehabilitation service. This can be captured in a range of metrics including rehabilitation success and ongoing care needs such as the number of patients admitted to care home beds or requiring increased care at home. However, 2020 and 2021 have been challenging times to draw direct comparisons as, like all health and care providers, unscheduled and scheduled care activity has been significantly impacted by the pandemic with a reduction in emergency presentations, and fewer patients requiring inpatient emergency hospital care.
The number of beds required for acute inpatient rehabilitation is accommodated within the bed base of the proposed new hospital at Overdale, and, importantly, these services may be required to function on more than one ward where patients in different specialist areas also require inpatient rehabilitation. This will mean inpatient rehabilitation will be wrapped around the patient rather than the patient being moved to one single ward to access rehabilitation services. Support services such as occupational therapists, physiotherapists and speech and language therapists will provide support to all inpatient areas of the new hospital where there is a designated need.

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