The ABUHB Acquired Brain Injury (ABI) Team and Niwrostiwt Neurological Conditions Recovery College

Aneurin Bevan University Health Board

In 2018 the Acquired Brain Injury (ABI) team in Aneurin Bevan University Health Board was struggling to meet demand with a high volume of referrals and difficulties with discharge. Problems at the front door were being managed through arbitrary exclusion criteria based on time since injury and injury severity. At the back door, service users talked about the gap between the services provided by the team and the support available to them in the community. This gap made it harder to discharge people, leading to increasing caseloads that further exacerbated problems at the front door. Feedback from staff and service users indicated that the situation was having an adverse impact on both groups.

The ABI team aimed to establish a culture of collaboration between ‘experts by training’ (healthcare staff) and ‘experts by experience’ (stroke and brain injury survivors). The intentions behind this aim were to empower people to live well by providing accessible, equitable, and timely support. The outcomes identified for the project were a greater sense of equity, safety through ease of access, connection, engagement, achievement, purpose and meaning. The team also sought to establish a culture of two-way learning supporting both recovery for service recipients and discovery for service providers. Two broad strategies were adopted to move towards the intended outcomes: the development of a Neurological Conditions Recovery College and to redouble efforts to embed the Care Aims Intended Outcomes Framework.

The Recovery College was co-created with service users and third sector colleagues to fill the gap between current health and third sector provision. Its novel approach replaces the current focus on therapy for sick people, with a focus on learning to live well.

The success of the strategies adopted have meant that time and condition specific entry criteria have been removed, widening access and reducing inequity. Moreover, the team have moved to a position where they operate without a waiting list