1. Burns Specialist Physiotherapy Outpatient Service Nigel Smith – Northern Burn Care Network AHP Lead Louisa Boyd – Burns Specialist Physiotherapist

2. AIM Demonstration of a transfer/teaching physiotherapy session with a patient who is being discharged from the burns outpatient service at Pinderfields Regional Burns Centre (RBC) to a District General Hospital (DGH) local to their home

3. Patient Martyn 61 year old male 21/07/11 10:15pm Gas explosion at patient’s home No first aid at scene Seen at local A & E department Transferred to RBC in the middle of the night

4. Patient 11.5% TBSA burns to face, forearms and both knees Mixed depth with extensive swelling especially the right hand Not deep enough to expose the extensor tendons 27/07/11 - Debridement of burns to hands and forearms and SSG (sheet to hands and mesh to forearms).

5. Physiotherapy Pre-op – stretches with pain control, education & elevation Splints for both hands Post-op – as pre-op with increased use of upper limbs as dressings allowed

6. Physiotherapy 05/08/11 - Discharged from RBC inpatient to outpatient PSDC 18/08/11 - Fully healed & discharged from PSDC Ongoing Physio and OT at RBC as out- patient

7. Telemedicine – Potential Patient Benefits Earlier transfer to local DGH for outpatient physiotherapy: Enabling patient to be treated earlier closer to home with more confidence in provider source Reduced travel cost - 260miles (Grimsby to Wakefield and return) 2 visits per week = £40 per week fuel.

8. Telemedicine – Potential Patient Benefits Reducing travel time – 6 hours total travel time per week (not including treatment time) Cost and time of someone to drive patient to RBC Close to family support network

9. Telemedicine – Potential Physiotherapy Service Improvements Earlier transfer of care of patient to local DGH enabling other patients access to regional burns beds Physiotherapist at DGH able to SEE treatment session and wound before receiving patient. Physio at DGH provided with increased confidence with manual techniques and enhanced guidance with wound reviews during treatment sessions

10. Telemedicine – Potential Physiotherapy Service Improvements DGH would have daily access to visual advice/education/support DGH could link into teaching and training sessions regionally without the need for travel costs and time Less need for patient to travel for review at RBC allowing treatment time for other patients Reduce amount of patients failing to attend appointments due to reduced travel costs and time Network wide in-service training

11. Telemedicine – Physiotherapy Financial Benefit Outreach travel saving of £60 per visit Outreach service cost of £62 per visit Average cost to Trust of travel and time per patient visit = £122

12. Telemedicine – Physiotherapy Financial Benefit Telemedicine ¾ hour max per treatment/teaching session Potential to meet an unmet recognised demand out of the current outreach resource

13. Summary Beneficial for patients; saving time and money, earlier discharge from RBC & closer to family Ideal model of treatment to outreach large rural area At present no physiotherapy system in place to monitor patients discharged to DGHs

14. Summary Support for DGH staff for burns patients Physiotherapy Burns Service development Opportunity for teaching Financial cost savings in travel and time for staffing, and increasing staff productivity

15. Questions? Thank you for listening