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Hillingdon Health and Care Partners have launched a new wellbeing support service to improve outcomes for patients being discharged from the Alderbourne and Daniels neuro-rehabilitation units at The Hillingdon Hospitals NHS Foundation Trust.

The pilot programme has been introduced as part of system wide improvement plan, which identified the potential benefit of providing very early, proactive wellbeing support for patients who need neurological rehabilitation.

These patients are often dealing with wide-ranging, long-term neurological symptoms, such as impairments to cognitive function, memory, speech, and physical mobility, which can affect everything from basic everyday tasks, to future employment opportunities, financial stability, personal relationships and their ability to achieve life goals. This impact can be life changing.

As a result, neuro-rehabilitation patients are often more vulnerable to physical regression, loss of confidence, anxiety, depression, social isolation and loneliness after discharge.

The pilot Neuro Wellbeing Support Service works alongside the multi-disciplinary team to support patients while they are on the wards and help them prepare for discharge. Working in close partnership with H4All, the new neuro wellbeing support officer, uses a person centred approach to help patients regain the skills, knowledge, and confidence to manage their long-term health needs (physical and mental), lead a better quality of life, redevelop social networks, and reduce the risk of loneliness and isolation post discharge.

Dr Ajoy Nair, consultant in rehabilitation medicine, said;

The H4All Team have been working hard behind the scenes to ensure that patients with life changing neurological injuries have a smooth transition back into the community when they are discharged from our inpatient neurorehab wards. The wellbeing support officers have a wealth of practical information and ensured our patients felt supported in their hour of need.

Sally Spring, neuro rehab officer added;

I am very happy to support people who have suffered a life changing illness and their families in navigating through the many services out there that can support them.

Many have no idea what’s available and this can be very daunting along with coming to terms with their illness and facing challenges they were not expecting resulting in a change of lifestyle. Gaining the support they need enables them to still have choice and control over their daily lives.

Early patient feedback has been very positive, Ronald Hearne said;

The information and support me and my family have received from H4All has definitely made a difference and given me peace of mind whilst I continue with my rehabilitation.

Fatima Ferndanes, another recent patient at the Trust commented that;

I wouldn’t have known about all the services and help available to me and my husband without H4All. I am really happy with the service and the help I received both on the ward and at home after my discharge.

Lalita Scott Transformation Director said

This is a great example of system working having a Wellbeing in-reach model as an earlier intervention working holistically to support a seamless discharge and continued support in the community if needed