Any acceptance and exclusion criteria. The decision to accept a child or young person for specialist neurorehabilitation, either as an in-patient or out-patient, will be related to their need or otherwise for acute medical management as well as their need for a neurorehabilitation programme. Patients will be accepted by neurorehabilitation when they acute illness has stabilised. In accordance with the National Service Framework for Children and Young People, young people aged 16-19th birthday will be offered the choice of paediatric or adult neurorehabilitation services. Acceptance Criteria Aged < 19 years Significant functional deficit as a result of ABI, ASI or other diagnosed neurological condition. Requires inter-disciplinary treatment Medically stable. No longer requiring regular input from acute medical or surgical teams Clear functional goals identified. Likely to benefit from programme of care. Parents/patient consent to participation in programme of neurorehabilitation. If there is uncertainty whether or not a patient can benefit from neurorehabilitation, then admission might be offered for a period of assessment. Exclusion criteria Age > 19 years Ongoing medical and/or surgical needs that cannot be met in the neurorehabilitation setting. Too medically unstable to benefit from neurorehabilitation therapy. Non- neurological diagnosis. Failure of parent/patient to consent to participation in neurorehabilitation programme. Appropriate specialist interdisciplinary assessment indicates that the patient is unable to benefit from a neurorehabilitation programme. This will rarely be the case in the paediatric setting.
Any acceptance and exclusion criteria. The unit will comply with local and national polices, guidelines and other conditions of commissioning as required (including, but not limited to, mandatory surveillance systems, antimicrobial stewardship, governance, patient safety alerts and NICE).
Any acceptance and exclusion criteria. NHS England commissions a range of services for devolved administrations, and these are renegotiated annually. The provider regularly reviews potential transplant recipients, and works with the wider diabetes community and renal failure services, to ensure appropriate referrals and equity of access for all patients. As a requirement of race, gender, sexual orientation, and religion and disability equality legislation, providers have a duty to co-operate with the commissioner in undertaking Equality Impact Assessments. Referral criteria, sources and routes Patients are referred from diabetic and renal services. The decision to recommend transplantation is agreed by the transplant surgeon and nephrologist or diabetologist, with input from other members of the MDT. The assessment process has four possible outcomes: • the MDT recommends a transplant; the patient agrees to a transplant and is placed on the waiting list. (This includes the outcome where the MDT recommends a live donor transplant with the possibility of a subsequent pancreas after kidney transplant) • the MDT recommends a transplant but the patient declines or wishes to defer the decision. The patient is given time and opportunity to revise this decision. He/she may choose to be listed for kidney alone • the MDT decides that the patient is currently in a stable condition that does not justify the risks of transplantation. For SPK, the patient is kept under review for possible reassessment at a later date • the MDT decides that the patient is not suitable for transplantation. The reasons for the decision are explained to the patient, his family and carers. Patients who disagree with the decision are offered the option of a second opinion at another transplant centre. The patient may be found suitable for kidney transplant alone There is no absolute exclusion criteria. Response time & detail and prioritisation Waiting times for transplant are dependent on organ availability. Prioritisation of organ allocation to centres is the responsibility of NHS Blood and Transplant.
Any acceptance and exclusion criteria. The service is commissioned by NHS England for all eligible patients from England and Scotland. The provider has a duty to co-operate with the commissioner in undertaking Equality Impact Assessments as a requirement of race, gender, sexual orientation, religion and disability equality legislation. See also BSUH trust policy on Equality and Diversity (2008). Referring corneal surgeons are asked to ascertain that both eyes (or the remaining eye for one-eyed patients) have poor vision of 6/60 or below. They are asked to ascertain visual potential in the eye to be rehabilitated. In other words, the patient should have corneal blindness alone, with a working retina and optic nerve. Tests to include a healthy B-scan ultrasound and sometimes electrodiagnostics. The referring surgeon should also ascertain the patient’s desire to regain vision, and that they are willing to commit to regular life-long follow up in Brighton and Hove. See Seminars article for contraindications, but briefly: • those under 18 years of age; • those with little or no visual potential; • those unable to attend life-long follow up in Brighton; • those unwilling to accept the appearance following OOKP surgery; • those who are adapted to blindness; • those who are psychologically frail, and who may therefore not be robust enough to withstand the possibility of renewed sight loss (especially after sight has been restored). The service has strict exclusion criteria including: • age • visual potential of the eye • family support • psychological robustness Patients are on an 18-week pathway, despite nationwide relaxation of this rule. Most of our patients are booked within 13 weeks, but OOKP referrals are usually seen much earlier in the pathway due to the existence of dedicated joint OOKP clinics.
