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Oxford University Hospitals NHS Foundation Trust
OCE

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Factors determining admission

The primary question we ask when considering a potential admission is:

Would admission to the Oxford Centre for Enablement offer this person something that will improve outcome over and above the outcomes from services already available?

If the answer is ‘yes’, then we will consider admission provided that funding is available. The questions that help inform this decision (and sometimes the timing of admission) are as follows:

Does the patient have a problem or condition within our area of expertise?

Namely:

  • any neurological disorder or neuromuscular condition
    • acquired or congenital
    • single incident (e.g. stroke), progressive (e.g. multiple sclerosis, Huntington’s disease) or fixed (e.g. previous spinal cord injury or stroke)
  • any clinical problem or problems arising from the condition, including secondary problems such as emotional problems, contractures or skin pressure ulcers
  • a condition that mimics a neurological condition (i.e. a functional disorder) [very rarely admitted]

Would admission be safe?

This usually excludes:

  • Patients who are physiologically (medically) unstable, usually equated to needing:
    • routine observations more than daily and/or
    • intravenous treatments on a continuous basis and/or
    • needing specialist observations and/or treatments delivered more that daily
  • Aged under 16 years (we do not have paediatric cover)

Would admission lead to a benefit?

This is determined as follows:

  • There is a clinically determined goal for the admission:
    • assessment of condition and prognosis, to inform management plans
    • provision of specific treatment(s) to achieve a change in activities

and

  • The patient has a new onset disabling condition, or a new problem in the context of a known, pre-existing condition

and/or

  • The patient has had or is at risk of a change in their condition requiring action.

and/or

  • The patient needs the involvement of a multidisciplinary specialist team.

Would an alternative be equally or more effective and/or efficient?

Would an alternative:

  • Meet the patient’s clinical care needs safely
  • Meet the patient’s rehabilitation needs at least as well, or better
  • Deliver the service in an appropriate and timely way
  • Using less (or at least no more) resources

Patients requiring extra time

Patients with the following needs are suitable for admission but may require extra time to ensure safe care is available:

  • on a ventilator or with a tracheostomy
  • wandering and liable to escape
  • unpredictably very aggressive