Developing transitional care across the world

By - World Healthcare Journal
Developing transitional care across the world

The Royal Buckinghamshire Hospital in Aylesbury is a privately owned specialist UK centre for complex, high intensity rehabilitation. With an array of highly trained specialists and innovation of both method and technology, Royal Bucks provides rehabilitation to patients with a wide variety of highly complex injuries and neurological conditions. Owing part of its original building design to Florence Nightingale in 1862, the cutting-edge treatment which defines the Royal Bucks today is steeped in rich tradition and history.

Andrew Norman, Hospital Director at Royal Bucks, has worked extensively with the highly motivated and dedicated team at Royal Bucks to develop the hospital’s model of care into one that can be used on a national and international basis. “We are up there with the best rehabilitation centres in the world and offer what we call ‘transitional, step forward care. ”

Based on the ‘Keiro Model’, a transitional model of care is one which harnesses the benefits of the integration of community and health services to provide a patient pathway that is both financially efficient and effective. Andrew envisages that this model can be used to establish Royal Bucks as a national rehabilitation hub within the UK, enabling acute hospitals to free up their beds.

The Royal Bucks overseas model

According to Chris Campbell, Business Development Director, this approach is not simply orientated for UK rehabilitation but can be universal in its application and adapted to fit the nuances of different countries. As such, Royal Bucks is looking to export its intellectual property and expertise in the form of specialist training and develop a series of long term relationships with overseas partners. This will enable the hospital to establish a global rehabilitation network, based around the principal transitional care.

“We want to join hands with overseas governments and organisations to operate a robust collaborative model,” says Chris. In the short term, patients would come from across the world with their own treating team, but as the years go by those physicians would be able to treat ever increasingly complex cases in their own country, thanks to their training at Royal Bucks.

Even after returning to their country of origin, patients and specialists would still receive ongoing support from the team at Royal Bucks. “The technology available enables us to monitor patients remotely via reports that tell us whether we need to interject, either because there is an opportunity for further improvement or there has been a deterioration in the patient’s condition,” says Andrew. A combination of online interaction and physical visits will allow Royal Bucks to continuously upskill and train rehabilitation specialists across the globe.

Chris is keen to ensure that any provision of Royal Bucks’ intellectual property, whether through specialist training or consultation, is used in a way that will facilitate a mutually beneficial long-term partnership. “It’s not about sending clients overseas a price list,” he says. “It’s about wanting to do business by developing strategic relationships. ”

Innovation in culture before technology

According to Andrew, despite patient access to any level of technology, without the proper culture, skill and the ability to motivate them, results will not be optimised. “Let’s take the example of the exoskeleton which can be a massive help to many patients. Assuming it is appropriate, unless a patient is in the right state of mind, it would be money wasted. At Royal Bucks we have the skills that put patients into the appropriate mindset,” he says.

Royal Bucks was the first centre in the UK to purchase an exoskeleton when the device came onto the market from the manufacturer, Ekso Bionics, which had their device FDA approved in 2016. With access now to all available variants, the hospital has become a leader and expert in this type of robotics. The aim of all variants is similar, to enable the patient to stand and walk utilising advanced robotics. “We have the skills to help patients understand that their life will be different, reveal the light at the end of the tunnel and show how their new life can be just as a successful and fulfilling,” Chris says.

It is this culture of rehabilitation that sets Royal Bucks apart from other organisations, even within the UK, and it is why they are the first organisation in the world to train a patient to use an exoskeleton in their own home.

The future of this care model

“Royal Bucks is a learning institution, with a theoretical-based operation that helps develop new techniques and ways of working,” says Andrew. “Over time, this speeds up the patient pathway, so that time spent in the facility is less and outcomes are better, with the aim that patients return to their community and back to their lives quicker and better. Given the authority and responsibility to develop the service in a way that is believed will benefit patients, coupled with very clear vision, a consistent process is developed. Then, individual country idiosyncrasies can be applied to this process. ”

The common denominator is the intellectual property that is needed to facilitate this change, and the Royal Bucks Hospital can offer this knowledge to clients across the globe.

“Our job is to keep improving what we do by measuring real life outcomes – do they allow patients to go back to work and live their life? ” adds Andrew. “We are constantly striving to make this happen quicker, through whatever mechanism is required, and it is this focus that separates our business from others. ”


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