Elysium Neurological has held its first Clinical Advisory Panel (CAP), to assist clinical teams in the provision of care for individuals with complex and challenging needs. The panel is comprised of leading experts within neurological rehabilitation and treatment and will provide advice and recommendations for three cases per meeting, following presentations made by the teams involved in the individual’s daily care
Convened to support teams at service level, the panel will draw on the wealth of specialist knowledge and experience that is present across the five different neurological pathways within Elysium, but is not always accessible to regional teams on a day-to-day basis. Paul Mooney, Clinical Director for Service Development & Improvement, Elysium Neurological Services, was instrumental in the development of the CAP and explains the reasons behind its launch.
Paul says: “We recognised that, collectively as a division, we have a huge amount of expertise across our five clinical pathways, and we wanted to ensure that there was a mechanism to be able to use this effectively to enhance patient care. The various clinicians within our services can now benefit from the ability to draw on each other’s knowledge and experience through the CAP, which is a formal panel that sits externally to a given service and that can be approached for advice around particularly challenging cases.
“On the balance of probability, every in-patient service will deal with complex and challenging individuals, and that can be a difficult and sometimes lonely place for clinicians. Sometimes we can feel that we have tried everything that we can think of to support a person, so it’s helpful then to get a fresh pair of eyes, to link in with peers from other professions, from other services, even other pathways, to think about different ways of doing things.
“By drawing on the most skilled clinicians available across our services, we can ensure best practice that helps the individuals who use our services to get the best level of care possible.”
Elysium Neurological operates five neurological pathways across ten services throughout England. The pathways (Neuroprogressive Conditions, Complex Physical Conditions, Complex Dementias, Neurorehabilitation, Neurobehavioural Rehabilitation) provide specialist neurological treatment, care and rehabilitation for individuals with a variety of different complex needs. For Paul Mooney, the CAP was a natural step in formalising how clinicians already support each other.
Paul says: “There are similarities in how services operate in neurological care but within each of those pathways, clinicians may approach people and problems in a different way. So, if there is a particular case where one approach is not yielding the best outcomes, it is good practice to reach out to others to reflect on a possible solution. Therefore, the development of CAP was actually a very logical move, it felt like an evolution of our overarching team-based philosophy of care.”
Louise Smith is Registered Manager and Executive Hospital Director at Badby Park Care Centre, and although she is a panel member for CAP, she joined the first meeting along with members of her team, to present and discuss a complex case. Here Louise shares her motivation for participating in CAP and why she felt the process was beneficial not only to the resident, but also to herself.
Louise says: “I’m a mental health nurse, but I’ve always worked in neurological services since I qualified 25 years ago. So, I’ve developed quite a lot of knowledge and skills over that period of time with regards to challenging cases and individuals with complex needs. However, when you’re faced with a challenging situation each day, all of the time, sometimes you can’t find the answer, you don’t necessarily think outside of the box.
“Whereas a clinician with a more objective view, who is a step back from the everyday care, can offer advice and suggestions from a new perspective. Drawing on expertise from multiple clinicians is a continuation of what we do at service level, but CAP is about broadening that access and extending it across all our services, to bring in that additional knowledge and experience.
“I asked my clinical team, who work with this particular resident on a day-to-day basis to come and present her case, receive feedback and then implement recommendations. They felt very positive about the experience and really took the feedback onboard. They’ve started to implement some of the things that were advised, for example, they’ve been speaking to the dietitian and asking new questions. We’ve also been liaising with our visiting consultant, in regards to making some medication changes and he is now reviewing those.”
Louise and her team have already started thinking ahead to the next CAP and considering ways to develop them further.
Louise continues: “My team found it really beneficial, they enjoyed it and they’re already starting to think about other cases that they can potentially use CAP for. If possible I would like to involve the resident’s family more. Unfortunately for the case we reviewed most recently, we were not able to engage with the family prior to the meeting. We do have families who are very actively involved and present at the site on a regular basis, and I would definitely encourage them to participate if this was in regards to their family member.
“They are part of the team that’s providing care and support and their input is invaluable to that resident every day. They know them best, they know their history, what’s been tried before and what hasn’t. Understanding that history is really important when working with challenging needs.”
Shona Anderson, Regional Director of Nursing for Elysium Neurological Services, believes that CAP plays a vital role in ensuring quality of life for individuals with complex needs, and is an important learning opportunity for everyone who takes part.
Shona says: “For me there are two main reasons why CAP is so important. The first is continuing to ensure the utmost quality of life possible for the people that we support. We know that everyone who attends CAP wants the absolute best for those they care for, and that’s why they are asking for advice from the panel. Participating in CAP is a proactive way of ensuring that the individuals that use our services receive the most personalised and effective care and support that can be provided as a team.
“The second reason is that we often look to external companies for training and for individuals to come in and teach us, but actually we’ve got all these skills, experience and champions within our services. And because the care that we provide across our five pathways is so diverse, and often complex, then this expertise could be in mental health, or tissue viability, diabetes or end of life care for example.
“We have the whole range, but we often overlook those individuals and we don’t perhaps champion them enough.“CAP benefits everyone who takes part. When we listen to the experience of others and the problems that they are solving it makes us reflect on our professional experience and we realise that we have also overlooked some of our skills and knowledge. CAP is a great learning opportunity for us all.”
Margrid Jeffries is Head of Clinical Services and the Deputy Service Director at Gardens and Jacobs, a neurological centre in Hertfordshire that provides specialist services for men and women who have complex neurological conditions. Margrid joined the first CAP as a panel member and echoes the sentiments offered by Shona Anderson, and feels that even if your particular service is not presenting a case during CAP, it is still beneficial because the knowledge and suggestions can be brought back and shared amongst the wider team.
Margrid explains: “There’s a sort of inverse benefit to CAP that I didn’t really expect. For example, you might be sitting there as the ‘expert’, but because the discussion is detailed and covers a lot of ground, with input from multiple clinicians, you can learn new things and take the feedback to your service. There’s continuous learning and the quality improvement opportunity is always there.”
- Get the latest insights, blogs and news from Elysium Neurological over on their EveryExpert thought leadership hub: www.elysiumhealthcare.co.uk/neurological/every-expert/
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