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Background

In response to the emerging evidence on the likely increase in the Welsh population’s rehabilitation needs, the Welsh Government established a national COVID-19 Planning and Response Rehabilitation Task and Finish Group in May 2020 to consider the safest and most effective way to provide rehabilitation, including community based rehabilitation and recovery interventions for those with mental health conditions and those whose mental health and wellbeing was challenged by the coronavirus.

Terms of reference

The Rehabilitation Task and Finish Group was created to provide leadership and oversight in relation to the planning of and delivery models for access to rehabilitation services during and in the wake of the COVID-19 response. 

The scope of the Rehabilitation Task and Finish Group was restricted to those rehabilitation services deemed to be essential (life threatening and life impacting) which should continue to be provided throughout the outbreak, including through initial and any subsequent peak levels of COVID-19 illness for the following 4 population groups:

  1. people post-COVID-19: those recovering from extended time in critical care and hospital and those with prolonged symptoms of COVID 19 recovering in the community
  2. people awaiting paused urgent and routine planned care who have further deterioration in their function
  3. people avoiding accessing services during the pandemic who are now at risk of harm e.g. disability and ill-health
  4. socially isolated/shielded groups where the lockdown is leading to decreased levels of activity and social connectivity, altered consumption of food, substance misuse, the loss of physical and mental wellbeing and thus increased health risk

The group’s deliverables informed the work of the Welsh Government COVID-19 Response Essential Services (non COVID-19) Cell. The group also considered the planning and delivery of rehabilitation services to inform the Welsh Government Recovery Group’s work and the Strategic Programme for Primary Care post COVID.

The Group was not responsible for long term rehabilitation planning and guidance for Wales, although the work of the group and learning from this work will inform long term rehabilitation work.

The Rehabilitation Task and Finish Group was co-chaired by Ruth Crowder, Chief AHP Adviser, Welsh Government and Claire Madsen, Powys THB Director of Therapies and Health Science, Rehab Consultant.
Members were sought from:

  • Welsh Government policy teams
  • NHS Wales
  • local authorities/regional partnership boards
  • the third sector
  • a range of stakeholder groups (e.g. the Welsh Therapies Advisory Committee)

Members’ professions were wide ranging:

  • NHS executives
  • service planners and members of the NHS Delivery Unit
  • doctors
  • social workers
  • nurses
  • all thirteen of the allied health professions
  • those with an expertise in rehab
  • reablement and recovery
  • consultants
  • advanced practitioners
  • those working with adults
  • children, physical and mental health; and specialist hospital and community services

Group deliverables

The national rehabilitation framework was published by the Welsh Government in May 2020. This assists service planning for the anticipated demand for rehabilitation and recovery of both COVID-19 and non-COVID-19 populations in adults and children.

The national rehabilitation framework is underpinned by specific guidance on the rehabilitation needs of the four identified population groups who have been directly and indirectly affected by the impact of COVID-19.

An Evaluation Framework was also published that supports health boards, local authority and third sector services to evaluate the impact of rehabilitation in the 4 populations affected by the COVID-19 pandemic. This aligns with the National Clinical Framework and the principles of Value Based Healthcare.

Lastly, the Welsh Government published a modelling resource for the rehabilitation workforce. This offers a tool to help services identify the potential demand for rehabilitation and the capacity required to meet that demand in order to maximise people’s recovery. A virtual engagement event was held on 12 August to discuss the rehabilitation modelling resource to share information on the development and potential uses of a practitioner-led modelling tool.

Group recommendations on further national action

The Rehabilitation Task and Finish Group agreed that the Group had achieved its identified deliverables and should be stood down.

To help develop rehabilitation services as an integral part of the health and care system in line with the vision in A Healthier Wales and learning from the advances and innovation in response to the pandemic, the Group identified the following areas of future work needed best done once for Wales. These have been mapped to existing national programmes where this work is already underway or which could be considered as the vehicle for taking forward.

Table
Deliverable / Product Current Position
Systematic review of evidence and update of population specific guidance for each of 4 populations affected by the COVID-19 pandemic building on specific guidance Consider as part of HEIW national programme for AHP Framework and aligned to both the Unscheduled Care and Planned Care pathways work
Primary & Community Care rehabilitation guidance for vulnerable groups identified as having a higher risk of the impacts of COVID-19 Underway via Strategic Programme for Primary Care (Prevention and Wellbeing Work stream)

Targeted 7 day Primary & Community Care rehabilitation guidance

Underway via Strategic Programme for Primary Care (24/7 work stream)
National rehabilitation value based performance measures building on the Evaluation Framework Consider as part of HEIW national programme for AHP Framework aligned to Planned Care Programme and Unscheduled Care programme pathways work
Programme of engagement, testing and roll out locally of national tool for assessing the needs of the 4 population groups and planning capacity and skills of workforce building on modelling resource Consider as part of HEIW national programme for AHP Framework
Suite of role competencies to inform service and contract specifications Consider as part of HEIW national programme for AHP Framework
Identification of what aspects of rehabilitation could be delivered via digital platforms Consider as part of HEIW national programme for AHP Framework and aligned to Planned Care Programme pathways work

 

Annex A

Terms of Reference

Aims and deliverables

The Rehabilitation Task and Finish Group will provide leadership and oversight in relation to the planning of and delivery models for access to rehabilitation services during and in the wake of the COVID-19 response.
Scope.

The scope of the group is initially restricted to those rehabilitation services deemed to be essential (life threatening and life impacting) which should continue to be provided throughout the outbreak, including through initial and any subsequent peak levels of COVID-19 illness for the following 4 population groups:

  1. people post-COVID-19: those recovering from extended time in critical care and hospital and those with prolonged symptoms of COVID-19 recovering in the community
  2. people awaiting paused urgent and routine planned care who have further deterioration in their function
  3. People avoiding accessing services during the pandemic who are now at risk of harm e.g. disability and ill-health
  4. Socially isolated/shielded groups where the lockdown is leading to decreased levels of activity and social connectivity, altered consumption of food; substance misuse, the loss of physical and mental wellbeing and thus increased health risk

The group’s deliverables will inform the work of the COVID-19 Response Essential Services (non COVID) Cell.

The group will also consider the planning and delivery of rehabilitation services to inform the recovery group’s work and the Strategic Programme for Primary Care when this is stood back up post COVID.

Governance

The group will report upward to and submit its deliverables for sign off by the COVID-19 Response Primary and Community Care Cell.

A lead for coordinating each deliverable will be named.

Members of the group to report to their respective networks and organisations.

Frequency of meetings:

The group will meet via Skype twice weekly, subject to regular review.

To constitute a quorum, representation from each sector and group sub-group should be present at each meeting.

The group is not responsible for:

Long term rehabilitation planning and guidance for Wales, although the work of the group and learning from this work will inform long term rehabilitation work.

The group has identified the potential rehabilitation requirements of wider society as a result of the pandemic. 

Actions on the needs of wider society are outwith the scope of this group at this time.

Membership

Members of group
Name Role
Ruth Crowder Chief AHP Adviser, Welsh Government
(Co-chair) Claire Madsen HB DoTHS Rep, Rehab consultant
(Co-chair) Cathy White Coordinating Lead for Primary care Model for Wales
Gareth Hewitt/Kevin Francis Policy Lead for Chronic Conditions, self care and older people’s health
Shelley Davies/Christine Chapple Lead for care@home work stream and policy lead in SSID for partnership and integrated working(including Regional Partnership Boards)
Karen Jewell WG nursing lead and link to Essential Services Cell and Primary and Community care Cell
William Oliver HSSG COVID-19 Planning and Response Cell
Kerrie Phipps National AHP lead Primary and Community Care
Dr Jennifer Thomas  Rehabilitation consultant
Dr Julie Highfield Consultant psychologist
Sam Perera Delivery Unit, evidence base, demand and capacity modelling
Tracey Williams Field Hospital Surge capacity lead, CTM UHB (and IPOP lead)
Lynda Chandler Delivery Unit, Discharge to Recover and assess model lead
Wendy Wilkinson Head of Allied Health Professions Transformation, HEIW
Susan Wilson Physiotherapy Clinical Lead, Swansea Bay
Danielle Sapsford Research, Innovation and Improvement Hub Manager, Powys
Jacqui Thornton Asst DoTHS, Aneurin Bevan
Colin Gibson Rehabilitation Engineering, Cardiff and Vale and Healthcare Science Network Board rep
Mel Laidler Assistant Director, Primary Care, Community and Mental Health, Aneurin Bevan and Regional Partnership Boards rep
Michelle Price

Consultant Therapist for Stroke and Neurorehabilitation, Powys

Cathryn Thomas Assistant Director for Improvement, Social Care Wales
Annie Price Clinical Fellow, Cardiff and Vale
Lisa Love-Gould Therapies Manager, Velindre
Michelle Kirkham North Powys Team Lead Radiographer
Aled Davies Association of Directors of Social Services (ADSS) Cymru Representative
John Brice/Stephanie Andrews/Rachel Cooper-Jones Secretariat