A whole pathway approach to regional spasticity service improvement

ABSTRACT

Introduction: Spasticity is a highly prevalent and complex symptom of neurological insult/disease and gaining consistency in a MDT approach at the acute, rehab and community level is challenging (RCP 2018). Across Greater Manchester (GM) (3.2million residents and 7 NHS Trusts) there is wide variation in spasticity service provision within stroke and neuro services creating inequity across the region. GMNISDN have therefore been working with regional colleagues to understand current practices and to establish a model of best practice for spasticity management across GM. Method(s) MDT working party established across stroke and neuro, inpatients and community to * Scope current practice and patient need (2019). * Review relevant literature, guidelines, and evidence-based practice. * Scope different delivery models across the UK. * Create GM Best Practice Model for Spasticity Management (2020). * Pilot audit a representative sample of services against national standards and GM model (2020). * Host spasticity education conference (2019) and webinar series (2021) to aid education around pathophysiology, assessment and management of spasticity. Result(s) * Spasticity service provision is varied, and at times underresourced and discoordinated. * Areas of good practice, training needs and areas for improvement identified (e.g. access pathways, waiting times and follow-up). * Importance of MDT collaboration in treatment planning and evaluation highlighted. * GM Best Practice Model used to aid clinical decision-making and to educate clinicians. * Training events attended by GM and national colleagues and rated excellent. Conclusion(s) Access to appropriately resourced and coordinated spasticity services in GM is inequitable. Further work is required to understand the post-covid picture and explore pathway development/improvement across stroke and neuro services.