1. Keiro: A Success Story

2. Keiro: A Success Story… Alistair McDonald Business relationships Director, Keiro Keiro: A Success Story

3. Keiro: A Success Story

4. Who are Keiro? Keiro s current services What do we do? An opportunity for people to Regain and Retain Independence A social context for rehabilitation Our Core values Trust, Impacts, Collaboration, Passion, Innovation Keiro: A Success Story

5. The Keiro Team Specialist Nurses Medical Consultants Personal Assistants Physiotherapists Clinical Neuropsychologists Occupational Therapists Speech and Language Therapists Therapy Assistants Holistic & Beauty Therapist Activities Coordinator's Holistic Care Coordinators Housekeepers & Maintenance Keiro: A Success Story

6. Why change? Keiro: A Success Story

7. Keiro: A Success Story Internal drivers for change… Learning Curve Client experience and feedback Overcoming site limitations Overcoming identified blocks in the pathway Outcomes & impacts

8. Neuro Numbers: National Estimates External drivers for change Approximately 10 million people across the UK have a long term neurological condition They account for 20% of all acute hospital admissions 350,000 people estimated to need help with the activities of daily living because of a neurological condition 850,000 people care for someone with a neurological condition 10% of visits to A&E Departments, and 19% of hospital admissions are for neurological issues. 17% of GP consultations are for neurological symptoms Keiro: A Success Story

9. External drivers for change Keiro: A Success Story

10. PATHWAYS FOLLOWING DISCHARGE? BOTTLENECKS COST OF LONG TERM CARE LACK OF APPROPRIATE HOUSING AWARENESS OF THE POTENTIAL FOR BETTER OUTCOMES/ SAVINGS EDUCATION VOCATIONAL OPPORTUNITIES INFORMATION Removing blocks on the road to independence Keiro: A Success Story

11. Real partnerships matter The Big Win-Win Better outcomes, more aligned to personal life goals for clients and families Lower cost packages of care/support that genuinely meet client outcomes Less funding required in the long term and less requirement for accessing primary care services Fewer admissions to hospital A joined-up pathway Personalisation of services Early intervention to prevent deterioration in long term conditions Reducing unnecessary acute admissions and readmissions Joint-working Reducing long term costs through Quality, Innovation, Productivity and Prevention No single organisation can achieve this, transformation can only happen with genuine partnerships and co- production, Keiro: A Success Story

12. The Gateway Keiro: A Success Story

13. North of region specialised commissioners (NORSCORE) In 2009 NORSCORE issued a tender for the provision of complex specialised neuro and spinal rehabilitation services to be provided from a number of potential services across the north east strategic health authority region. Why Teesside? North East Neuro Science Network Report from internal Network Lead: Summary Neuro Rehabilitation Review 30% less time is spent in services with access to rehabilitation in the North of Region Patients admitted to James Cook hospital with an acquired brain injury have no or very little neuro support in the community after discharge. There is little access to vocational rehabilitation on Teesside Appropriate environment: Whilst the configuration of a service that replicates Walkergate Park will not be necessarily appropriate, facilities that promote a positive psychological response are desirable and part of the rehabilitative process e.g. Walkergate Park, North of England Traumatic spinal injury centre, Chase Park/Health Club. North East Public Health Observatory (NEPHO) Health Needs Assessment for Long Term Neurological Conditions in North East England Keiro: A Success Story

14. Regional Rankings for Inpatient and Day Case Elective Admissions (2009/10) 1. Hartlepool2. Middlesbrough3. Stockton on Tees4. Redcar5. County Durham6. Newcastle7. North Tyneside8. Sunderland9. Darlington10. Northumberland11. South Tyneside12. Gateshead Tees Need/Demand Teesside has the highest prevalence per 100k population for acquired brain injury, compared with regional and national levels 314 per 100k – Tees 179 per 100k - Nationally The Impact of Neurological Conditions: In Teesside Keiro: A Success Story

15. Why Middlesbrough? Keiro: A Success Story

16. Why Middlesbrough? James Cook University Hospital James Cook University Hospital is a designated as a National Trauma Centre. The Gateway is purposefully located within ½ a mile of James Cook University Hospital Ray Mallon (elected Mayor of Middlesbrough) visited Keiros existing rehabilitation facility Chase Park Rehabilitation Centre in 2009 and has been a strong advocate for the development of the Gateway ever since. Keiro: A Success Story

17. The Gateway: Project Timeline The Gateway: Public Consultation Event Middlesbrough College ' 08 Apr 2008 Nov Jun 2009 Jan 2010 Aug Mar 2011 Oct May 2012 Dec Jul 2013 ' 14 Gateway Opened 6/1/14 Gateway Build is Completed Dec 2013 TVDNY – Conference 8/3/13 Multi Stakeholder Conference 1/2/13 Multi Stakeholder Commissioning Event 2/11/11 Middlesbrough Health & Scrutiny Panel - Oct and Nov 2011 1/10/11 TVDNY Appreciative Enquiry Workshop 1/6/11 Multi Stakeholder Project Development Team established June 2010 1/6/10 Multi Stakeholder Scoping Event 1/3/10 Meet Chris Smith (MD Erimus) 1/2/10 Initial Council Project Development Team established 1/6/09 Meet Ray Mallon (Mayor of Middlesbrough) 1/1/09 Meet Glenys Marriott (Chair South Tees NHS Trust) 1/4/08 2/11/12 - 14/11/12 Keiro: A Success Story

18. SUPPORT NETWORKS Social Groups Events SELF MANAGEMENT Long Term Conditions Expert Patient Programmes KNOWLEDGE CENTRE Advice Signposting Accessing Information EDUCATI0NAL AND VOCATIONAL Partnerships with Colleges and Universities Vocational Rehabilitation Opportunities ADVOCACY Supporting Clients Supporting Families 3 RD SECTOR PARTNERSHIP S Working with Partners on Site Working with Community Groups HEALTH PROMOTION Outstanding Accessible, Exercise and Facilities Alternative and Holistic Therapies Community Wellbeing Hub Keiro: A Success Story

19. A pathway towards independence Reducing delayed discharge from acute services Early intervention and on-going rehabilitation Step up services to reduce unnecessary acute admissions and readmissions Joint-working between Health, Social Care, Education, The Third Sector/Social Enterprise & Independent Specialists Services Step forward housing Reducing long term costs through Quality, Innovation, Productivity and Prevention Partnership efficiencies Joining the dots Keiro: A Success Story

20. AHSN: How have Keiro benefitted? Input: We are looking to start develop transitional housing in Gateshead the AHSN carried out a piece of research to We are looking to start develop transitional housing in Gateshead the AHSN carried out a piece of research to support this support this Working with local CCGs to understand the benefits of working with us at Chase Park Neuro Centre Working with local CCGs to understand the benefits of working with us at Chase Park Neuro Centre Networks: Helping us get in front of the right people to support The Gateway. Very important for a small organisation! Networks: Helping us get in front of the right people to support The Gateway. Very important for a small organisation! Ongoing advice, support, research and partnership working Ongoing advice, support, research and partnership working Keiro: A Success Story

21. The Gateway Regaining and Retaining Independence Summary Keiro have an ambitious plan to grow. The AHSN will be a key partner in supporting us to: Expand the organisation Improve health outcomes Generate wealth Create new jobs Keiro: A Success Story