NHS Greater Glasgow and Clyde does have some good services for people with brain injury. However, Headway Glasgow works with people who travel in from other areas because there are no services there (like people from Kilcreggan, Motherwell, Dumbarton) – could we not see NHS Glasgow being used as a model to improve services in the rest of Scotland? What would be the next step in doing this?
Firstly, I have conveyed your positive comments about NHS Greater Glasgow and Clyde’s services to our Acute Division and, on behalf of colleagues, wish to thank you for making them.
Before turning to national initiatives, I would like to say something about the local context to Brain Injury Services. We have an extant Acquired Brain Injury Strategy and action plan for Greater Glasgow. A planning sub-group of the Disability and Rehabilitation Planning and Implementation Group is also in place and, currently, there is a separate Acquired Brain Injury planning group in West Dumbartonshire whereas in other areas this function is covered by Physical Disability planning processes.
Although we do have good services in Greater Glasgow, as you point out, there are gaps and issues we need to address. In particular, we need to develop provision in relation to the first 48 hours after injury, when patients are admitted to a variety of wards on each acute receiving site. Similarly, we need also to do more in slow-stream rehabilitation where we purchase placements with private providers outwith the NHS Board area.
Part of our response is to appoint a second Head Injury Nurse within Glasgow to provide specialist support to acute wards where brain injured patients are cared for – appointment of the nurse is imminent as interviews were on 13th August 2008. Additionally, the Brain Injury Rehabilitation trust is to build its new national centre in Springburn and this will allow us to place patients needing slower-stream rehabilitation closer to home.
We are also beginning further integration of social and healthcare services in the Community Treatment Centre and working with Glasgow City Council to commission care home beds for patients with a brain injury and to provide specialist health support to those beds.
Clearly, we are doing our best to continuously improve our existing services and we are very happy indeed to work with colleagues from other NHS Boards to share our experience. One practical step towards this is our invitation to the Scottish Government’s Joint Improvement Team to review our services and to suggest areas that require further development or integration. This will be beneficial to us in terms of better services but, I am sure, will also build the ‘knowledge bank’ that can be shared nationally.
At national level, as you may be aware, there are further opportunities for closing working between NHS Boards. A national Managed Clinical Network for Acquired Brain Injury has been established and this has issued draft standards for Traumatic Brain Injury in Adults for consultation. The network has asked for comments on this to be made by 31st October 2008. Once agreed, these would represent national standards for services, although planning and delivery would remain local and mainly planned jointly with local authorities.
The network’s wider aims are to map out services for people with an Acquired Brain Injury, promote recognised standards of care and identify consistent information needed by patients, families and carers.
The work on standards is particularly important in ensuring that people will receive the care they need wherever they live in Scotland. The Scottish Intercollegiate Guidelines Network (SIGN) is currently revising its guidelines on early management of head injuries. This is due for publication next year and will contain recommendations on management of head injuries based on the most recent international evidence. Each NHS Board, including Greater Glasgow and Clyde, will be obliged to ensure local services meet these standards.
Early in 2007, the national Delivery Framework for Adult Rehabilitation in Scotland was published. This is to lead to the setting up of a Rehabilitation Framework Implementation Group that will be tasked with ensuring the framework is taken forward.
A further national initiative is a Managed Knowledge Network for self-management and rehabilitation, which was launched last April. This includes information for patients and carers about Acquired Brain Injury. The purpose of the network is to enable patients, carers and health and social care practitioners to share and assess advice, information and evidence around adult rehabilitation and the management of long-term conditions. You can be assured that we are playing a full part in the network.