Agenda item

This report gives an update on changes to the way adult musculoskeletal physiotherapy hydrotherapy services are provided at Charing Cross Hospital and pilot trials undertaken to support a change in delivery.

5.1           Professor Tim Orchard, supported by Imperial Trust health colleagues Charlotte Allenby and Anna Bokobza, provided an update on changes to the way adult musculoskeletal physiotherapy hydrotherapy services were provided at Charing Cross Hospital and pilot trials undertaken to support a change in delivery.  He Commended the collaborative work with Councillor Ben Coleman, Lisa Redfern, and H&F senior social care staff to develop robust changes to the hydrotherapy service model through active engagement with residents.

5.2           The committee were provided with a timeline of key activities between October 2018 and February 2022 which saw a temporary closure of the hydrotherapy facility due to prohibitively increasing maintenance costs and service unpredictability.  An options appraisal in October 2018 had initially prompted a change in how aquatic therapy should be delivered and concerns about maintenance.  This latter issue had led to numerous unplanned cancellations and poor service provision for patients.

5.3           The outcome of the engagement led was a two-part pilot project in February 2019.  Part one included the temporary use of pool facilities at the Jack Tizard school site. The second part involved the use of the pool at the sports club on the Charing Cross hospital site for those who were transitioning towards self-directed care and recovery. The two pilots were run in tandem and evaluated but unfortunately the pandemic meant that there was a hiatus, and the projects did not properly commence until after the third wave in February 2022.  The results of the pilots were included in the report together with generally positive patient feedback, although accessibility issues were highlighted.  It was anticipated that the proposal would be to permanently close the existing therapy pool at the Charing Cross hospital site and to continue with the two pilot services across two sites.  This would improve patient experience, and address maintenance and cost issues.

5.4           Councillor Lloyd-Harris welcomed the summary and update, which had improved on the April 2019 report to the committee.  Recognising that there were limitations on the use of the Jack Tizard school site she asked if the option to further develop the Charing Cross sports club site had been explored, querying whether the limited use of the school site was sufficient to provide a robust service.  She also referenced the views of a local GP who had actively contributed to the April 2019 committee discussions by outlining his patients’ difficulties in obtaining referrals to the hydrotherapy pool and queried why this remained unchanged, given the demand.  Merril Hammer commended the Trusts response which sought a solution that recognised the value and benefits of aquatic therapy. Councillor Richardson emphasised the importance of including the “patient voice” through stakeholder engagement and commented on the disruption to the pilots and asked about the level of assurance testing undertaken.  Councillor Coleman welcomed the Trust’s encouraging approach and asked whether this could incorporate additional hours at the Jack Tizard site during school break periods or if patients could be transferred by Uber from the hospital site, given the significant savings achievable from not maintaining capital investment in the current hydrotherapy facilities.  The issue of the changing rooms issue at the Charing Cross site was also raised.

5.5           In response to Cllr Lloyd-Harris’s questions, Professor Orchard felt that the referral pathway from clinicians to the service was appropriate but there was a concern that the temporary service might become overloaded.  It was confirmed that there was an option to extend the hours of use at the Jack Tizard site with further investment, provided that the logistics permitted this. Professor Orchard agreed that a proper evaluation of an extended period of the pilot services was required.  The points raised by Councillor Coleman were regarded as reasonable and Professor Orchard agreed to explore these further following the meeting but caveated a need to balance the suggestions against other competing priorities.

5.6           Professor Orchard indicated that it had never been the Trusts intention to close the facilities as a cost saving exercise, but the evidence base supporting aqua therapy was insufficient across the range of conditions, although specific benefits were acknowledged for some such as axial spondylarthritis.  Anna Bokobza added that it was important to maintain a service that was accessible to patients in both the north and south of the borough and to consider the logistics of delivering a service across two sites. She felt that a proper evaluation of the pilots should be based on minimum of 12 continuous weeks of operation without interruption to achieve robust evidence-based outcomes and informed decision making.  Councillor Coleman commended the Trust response, recalling that they had received robust challenge at the April 2019 PAC meeting and that health colleagues had responded with openness and accountability. 

RESOLVED

That the report be noted.