NHS trusts visit VAMED rehabilitation sites

UK healthcare decision-makers travelled to Austria this year to see first-hand the European model of neurological and musculoskeletal rehabilitation.

VAMED hosted visits to their state-of-the art facilities with their partner Circle Health. The healthcare providers invited several NHS trusts in line with the providers’ vision to spread the rehabilitation model here in the UK.

Circle Health and VAMED formed a joint venture to launch ‘Circle Rehabilitation’. It is a European-style rehabilitation service, centred at Circle Reading Hospital, UK.

Circle Health is experienced in delivering new facilities as well as partnering with the NHS. VAMED runs over 800 health projects in 79 countries worldwide. It is one of the largest providers of rehabilitation in Europe with more than 30 years’ experience in this service.

The European model of rehabilitation aims to alleviate the strain on acute hospitals – and taxpayers’ liability. The solution is opening specialised rehabilitation hospitals and units with high-tech equipment and multidisciplinary teams, at scale. The model shifts the patients’ and their families’ roles from passive recipients of care to active participants. This way patients move back to an independent life as soon as possible.

NHS trusts from around the UK sent their senior representatives to the visits: usually the CEO or COO, lead therapists, doctors (especially orthopaedic, geriatric, neurological) and head nurses. Each trust split their day into exploring two sites: the Neurological Therapy Center Kapfenberg (NTK) and the Rehaklinik Wien Baumgarten (see descriptions below).

At the rehabilitation centres, multi-disciplinary staff corroborate with every patient on an individualised therapy plan. A neurological patient, for example, could have a day schedule of cognitive group therapy, underwater strengthening, individual speech therapy, group lunch, strength training, individual physiotherapy and computer group therapy. An orthopaedic patient’s day could involve occupational therapy, group therapeutic gymnastics, physiotherapy, ultrasound, endurance training, group lunch, individual psychological counselling, ultrasound, underwater training and strength training.

VAMED Rehaklinik Baumgarten

The visitors saw high quality medical technology. Some NHS trust staff could try the equipment for the first time in their careers, such as the anti-gravity treadmill.  Visitors saw neurorobotic equipment (for gait-assisted therapy) and gait analysis machines. They walked through the occupational therapy spaces: kitchens (where patients learn to cook again), handcraft rooms (where patients learn manual tasks again, such as hammering a nail) and therapy gardens (where patients learn to garden again). The groups also visited the accommodation, patient lounges and dining rooms. A stroke, for example, can make eating a challenge for a patient. A supervised dining area breaks the mould of common UK rehabilitation practice. Rather than patients eating in their room, communal dining gradually mobilises them back to an independent lifestyle.

Circle Health, VAMED and the delegations of the UK healthcare met at the end of the site visits. They discussed opportunities for collaborating on future ‘European-style’ rehabilitation projects in the UK.

VAMED and Circle Health proposed scaling up the European model in the UK. Integrating the European model of rehabilitation into the UK health system will fill the gap between acute hospitals and care at home. The healthcare providers also urged the UK healthcare delegations to consider better standardisation to optimise rehabilitation, such as the International Classification of Functioning, Disability and Health (ICF).

Neurological Therapy Center Kapfenberg

Treatment: neurological post acute (early) rehabilitation; management of chronic neurological diseases or conditions (e.g. Parkinson, MS)

Beds: 70

Employees: multi-disciplinary model of medical, nursing and therapeutic personnel. 120 (FTA), 160 (Heads)

Partner: KAGes (regional state hospital holding)

Medical Services: physiotherapy, occupational therapy, speech therapy, neuropsychology, enabling rehabilitation care, dietology, painting and creative therapy, electrotherapy, massage

Equipment: gait rehabilitation with robotics (Lokomat and treadmill), Ultrasound, EEG, EMG, endoscopic evaluation of swallowing

Profile: NTK is a prime example of social progress in healthcare. It was originally a private factory hospital for the city of Kapfenberg’s largest employer, the steel manufacturer Böhler GmbH. Since VAMED took over operation in 1991, the hospital has evolved into Austria’s only neurological rehabilitation clinic on the social insurance system. From 2005 to 2015, the proportion of NTK patients retransferring back to an acute hospital has dropped from 8.4% to 5.7%. In the same period, patients discharged to nursing homes dropped from 13.1% to 9.9%.

Rehaklinik wien Baumgarten

Treatment: musculoskeletal and neurological rehabilitation ; conservative orthopaedics

Beds: 222 beds

Employees: multi-disciplinary model of medical, nursing and therapeutic personnel. 108 employees

University partners: Medical University Vienna Orthopedics, Danube University Krems. Technical university Vienna

Hospital partners: AKH Vienna, Wilhelminenspital, Otto-Wagner Hospital, Hospital Barmherzige Brüder, Orthopedic Hospital Speising

Medical Services: Activating care, physiotherapy and remedial gymnastics, occupational therapy, electrotherapy, balneotherapy, gait analysis and training, therapeutical and relaxing massage, dual task training, manual therapy, pain therapy, health education and prevention, adjustment of medication, diet counselling, Traditional Chinese Medicine, clinical psychology, sports therapy, X-ray-guided facet joint infiltration, Spineliner, ESWT (extracorporal shock wave therapy), FDM (fascial distortion model), osteopathy

Equipment: virtual reality-training, virtual footprint-projection, AlterG antigravity treadmill, sling therapy, red cord system, aqua-therapy pool, chip-control-function on physio-training-machines, active and passive posturographic diagnosis and trainings system (Sensewave), Dual Task Training (SilverFit, Amadeo, Pablo)

Profile: Rehaklinik wien Baumgarten is a pioneer in rehabilitation, establishing amongst the first-ever musculoskeletal and neurological rehabilitation clinics in Vienna. Its network spans across partnerships with prestigious universities and hospitals. Patients benefit fro m top quality hospitality: single rooms with views over Vienna, accommodation for family members, freshly prepared and traditionally cooked menus, bathing and sauna , concierge and special arrangements such as guided tours of Vienna’s City Centre.

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