Neuro-rehab professionals acted fast in the coronavirus crisis, according to Chief Allied Health Professions therapies advisor for the Welsh government, Ruth Crowder.
“Instantly, we realised the implications of the pandemic,” she says.
“We looked at what we could do remotely with services and developed a rehab framework really rapidly,” Crowder says. “We identified that this was going to become an issue, so Wales moved really quickly to implement a framework.”
The Welsh government supported the introduction of ‘attend anywhere’ video consultation and telephone advice for primary care across a range of services across several provisions, including numerous Allied Health Professionals in neuro rehab.
It’s been rolled out for a year to test its suitability, with a view to continue using it in the future, Crowder says.
“We introduced a number of electronic tools to assist people, including remote telephone assessments where people can phone up for advice whenever they need it, and some services put advisory videos online to help people undertake rehab in their own environment when they’re not coming into services.”
Most services looked at a major risk assessment of who needed to be seen because of an urgent or critical need, and who can be safely managed remotely, Crowder says.
“There were different tools around different ideas, so it was about matching tools to individuals. It’s important we don’t leave people out and alone but that everyone can equally access support.”
The rehab framework AHP published has considered four main population groups.
“We identified a need for rehab for those recovering from Covid-19, those admitted to hospital, and who were managed in community, and also a demand for people with other conditions who may have had services paused or delivered in different way.”
“There’s also potentially going to be rehab needs for those who may not have come forward but had developments during this period.
“A&E attendances went down, and we don’t know at the moment if there was a drop in incidents or if people didn’t present at services because of lockdown, so we don’t yet know what the rehab demand will be for that.”
The fourth group is the population that have been shielded and are isolating and probably haven’t undertaken as much activity as they normally would do, Crowder says, who were coping without intervention before but, as a result of reduced activity levels, have become more deconditioned.
“We’ll need to think carefully about what the demand is and how we respond to that with timely services.”
The experience of staff since the beginning of the pandemic, Crowder says, has been dependent on how services adapted in response to the initial crisis, and the rates of Covid- 19 cases in and around Wales and the kinds of surges that were anticipated or experienced.
Some Allied Health Professionals were redeployed to deal with acutely unwell people, and boards and trusts across Wales are now planning how they return staff to services, as well as how rehab services will meet demand.
“Our expectation of the pandemic is increased demand for neuro rehab, and growing evidence is showing the range of needs people have following Covid-19.”
However, the hard work and adaptability of professionals working across neuro rehab services has given Crowder confidence that the next challenges will be met.
“If any good comes out of this horrendous situation, it’s the way people have worked flexibly and creatively to identify the needs of patients. It’s been inspirational to be part of,” she says.
“Getting the framework up and running came down to an amazing collaborative and multi-professional approach.
It’s been a well-integrated process; not just clinicians, but also service planners and managers, who’ve worked as huge collaborative group.
“I’m the lead but that’s nominal – it’s been a huge team effort, really worked outstandingly, where working collaboratively across boundaries, keeping the patient centre of all planning, has been exciting, and I hope this continues.”
