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Publication Effect of reducing physiotherapy referrals from care homes on waiting lists through health promotion, physical activity, and falls prevention(South Warwickshire University NHS Foundation Trust, 2025-05-08) Asaju, Oluwadamilola; Knight, Sophie; South Warwickshire University NHS Foundation Trust; Physiotherapy; Allied Health Professional; Asaju, Oluwadamilola; Knight, SophieBackground Long waiting lists for appointments within the NHS have been an ongoing issue for some time, and it remains an essential aspect of service improvement. The NHS's long-term plan aims to shift the model of care further upstream with a focus on preventive care, closer integration of services within the community for people with chronic conditions, and reduced outpatient visits by a third. Aims • Reduce referrals from care homes by 35% within 6 months. • Reduce waiting times for referrals by 30% within 6 months. • Reduce carbon emissions associated with travels by 30% within 6 months. • Potential financial and time savings of approximately 30% within 6 months. • Improve quality of life of residents. Measures • Total referrals received • Average waiting time (days) • Total face-to-face (F2F) visits • Total mileage • Total mileage expense claim • Social impact on staff • Patient’s quality of life (QOL) Changes • In conjunction with Warwickshire County Council, we organised a webinar for social care workers in June 2024 and uploaded this resource onto the Social Care Information and Learning Services (Scils) portal in the same month. • Alongside the therapy triage clinicians, we developed a new care home referral document in October 2024. Achievements and results • Total number of referrals was reduced by 33% and 31% in Stratford and Warwick, respectively. • Average waiting time was reduced by 33% and 70% in Stratford and Warwick, respectively. • Total F2F visits was reduced by 54% and 46% in Stratford and Warwick, respectively. • Total mileage driven was reduced by 61% and 62% in Stratford and Warwick, respectively. • Total mileage expense claimed was reduced by 61% and 62% in Stratford and Warwick, respectively. • Carbon savings (0.3386kgCO2e per mile driven): 874 and 1368 in Stratford and Warwick, respectively. • Financial savings (£144 per appointment): £28,512 and £46,224 in Stratford and Warwick, respectively. • Time savings (90 mins visit): 297 mins and 482 mins in Stratford and Warwick, respectively. • Care staff reported improved knowledge, ideas, and skills, increased knowledge of equipment, better understanding of the importance of exercise, and key contact information. Future considerations and learning • Collect data for the same months in 2025 to assess if impact has been sustainable. • Making every contact count • Provide further learning opportunities for social care workers based on feedback received.Publication How can I help older people in hospital get home sooner and prevent deconditioning?(RCN Publishing (RCNi), 2017-06-30) Jennings, Jo; South Warwickshire University NHS Foundation Trust; Orthogeriatrics; Allied Health Professional; Jennings, JoWhat staff can do to help older patients return home more quickly. Concerns about the complications of prolonged bed rest were raised as far back as 1947 (Asher 1947). Hospital stays are associated with iatrogenic infections, medication errors, increased risk of delirium and side effects of prolonged bed rest (Inouye and Charpentier 1996, Covinsky et al 2011).Publication A thematic synthesis considering the factors which influence multiple sclerosis related fatigue during physical activity(Elsevier, 2020-05) Mezini, S.; Soundy, Andrew; South Warwickshire University NHS Foundation Trust; University of Birmingham; Physiotherapy; Allied Health Professional; Mezini, S.; Sounday, A.This thematic synthesis considers the factors which influence fatigue during physical activity in patients with multiple sclerosis.Publication Utilising a specialist orthopaedic home support team to provide rehabilitation post fracture neck of femur during the COVID pandemic(Elsevier, 2022-02) Kelly, M.; Hickman, R.; Kirkwood, R.; Morgan, A.; Saunders, Paul; South Warwickshire University NHS Foundation Trust; Physiotherapy; Allied Health Professional; Kelly, M.; Hickman, R.; Kirkwood, R.; Morgan, A.; Saunders, P.Purpose: The national Hip Sprint audit highlighted poor mobility outcomes following neck-of-femur fractures (NOF#) with up to 60% failing to return to pre-fracture mobility level. The standard community rehabilitation provided by our Trust included long waits and basic levels of rehabilitation provision. Our elective arthroplasty pathway incorporates a specialist orthopaedic home-support-team (HST) whom visit patients in their homes after in-patient discharge to provide rehabilitation and joint management. COVID-19 placed unprecedented demands on inpatient bed capacity and community service provision with the need to prevent long length of stay. Whilst elective orthopaedics ceased during the second wave, our aim was to determine if early specialist community intervention following NOF# results in low length of stay and provides clinically significant improvements in patient outcomes. Methods: We performed a two-month pilot study (December–January 2020/21) for all NOF# cases at an NHS district general hospital. The inclusion criteria for specialist HST involvement were the capacity to follow commands, absence of complex social-care needs and the ability to step-round transfer with/without equipment. Outcome measures were time to first contact, number of contacts, Berg Balance score, mobility status, ongoing referral requirement and patient subjective feedback (iWantGreatCare: questions 7,81,97,98). Results: There were 73 NOF# cases occurring across the 2-month study period with 23 (32%) cases meeting the inclusion criteria for specialist HST. Eight patients (11%) passed away during the pilot period, one was seen by the HST. One case seen by the HST ultimately required revision-surgery. The mean age of cases seen by the HST was 78 years (range 51–96). Surgical management comprised of hemi-arthroplasty (8), intramedullary-nail (6), total hip arthroplasty (6), and dynamic hip screw (3). The mean length of inpatient stay was 8 days (range 1–33) with all patients returning to their usual place of residence. All patients’ received telephone contact within 24-hours and the medium time to first community contact was 4 days, with patients receiving on average 3 visits (range 1–8) over a mean 21 days. Over 80% (17/21) of patient improved their mobility status from inpatient discharge to HST discharge (mean 20 days). Within 3-months of surgery, 15 cases returned to their pre-fracture level of mobility, including 8 who are mobilising independently. The Berg Balance score was completed in 14 patients with 11 achieving a clinically significant change (>6.5). Thirteen patients did not require any further healthcare input and four were able to be managed in an out-patient setting. Patient reported outcomes showed 100% patients scored 5/5 on all questions. Conclusion(s): A third of NOF# cases were eligible for the HST service. We have demonstrated specialist HST involvement achieves significant improvements in balance and mobility with high levels of patient satisfaction. In one case, a patient who sustained a NOF# a year previous and a second during this pilot managed to return to primary pre-injury mobility with the assistance of the HST, despite failing to achieve this after their first injury. Impact: Utilising a specialist orthopaedic HST may reduce the strain of inpatient capacity and traditional community rehabilitation services however further investigation is required.Publication Help I’m the On Call Physio! Does simulation help newly qualified physiotherapist prepare for being the on-call respiratory physiotherapist?(Elsevier, 2022-02) Jennings, J.; Bragg, E.; Clarke, G.; Shanmugam, R.; South Warwickshire University NHS Foundation Trust; Physiotherapy; Anaesthetics; Allied Health Professional; Medical and Dental; Jennings, J.; Bragg, E.; Clarke, G.; Shanmugam, R.Conference abstract from Virtual Physiotherapy UK 2021 Conference.