how it began

Toria Chan and Jules Leahy, the two sisters in the team, are passionate about ‘Care’ being the prime enabler to any sort of recovery and well being. It has been a defining factor in their professional and family lives and for five years they have been refining and researching how they can put that passion into practice.

Toria, our Clinical Director, a physiotherapist with over 20 years experience, spent some time working at St Luke’s hospice in Sheffield, a place for people with life limiting conditions. At the weekly team meetings when the discharge plans for patients were being discussed, it became clear to Toria that there were no suitable placements for those under 60 who needed further care and the only options were elderly care homes. This was also true of other younger patients in hospital needing on-going care. So her first idea was to set up a residential facility for them and to focus on providing the best care possible with physiotherapy where appropriate.

After doing the maths, this in itself didn’t stack up as a business model and after some research with Jules they realised that if an intensive multi-disciplinary rehabilitation element was added to the care element, this would be a better model. So, which younger patients needed good quality rehabilitation?

We started our in depth research and after meetings with several key people involved in the acute provision of rehabilitation, as well as those involved in commissioning further rehabilitation, we quickly identified the need for a centre for stroke survivors who needed ongoing intensive rehabilitation and emerging statistics were showing that 26% of strokes are in the under 65s. Radio 4 March 2nd 2014 Brain Attack

Toria and Jules visited many care facilities, both locally and nationally, providing different levels of care and rehabilitation, and of course, Sheffield’s own Royal Hallamshire Hospital (RHH), a centre of excellence for acute stroke care in the area. They met up with the clinical lead for strokes there, to identify where the greatest need was and how STEPS might fit into the recovery pathway.

Following this meeting Jules and Toria started to see the real problem. There was nowhere locally to send patients on to from the hospital for intensive rehabilitation, not only following a stroke or brain injury but also after multiple trauma injuries.

Sheffield is well placed – it’s teaching hospitals achieved the status of “Major Trauma Centre” for adults and children in 2012 and it is also home to The Regional Spinal Injuries Unit, with the RHH a centre of excellence for acute stroke care.

“Around 1,000 people sustain a spinal cord injury each year in the UK and Ireland. Spinal cord injury primarily affects young adults involved in accidents and is most common in those between the ages of 15 to 38 years.”, spinal-research.org

There were 348,934 UK admissions to hospital with acquired brain injury in 2013-14. That is 566 admissions per 100,000 of the population.  ABI admissions in the UK have increased by 10% since 2005-6.”These statistics make for uneasy reading,” said Luke Griggs, Director of Communications at Headway. “Every 90 seconds someone is admitted to a UK hospital with an ABI-related diagnosis that could lead to significant long-term disability, with the number of people affected increasing year-on-year. “Such a significant increase in the number of people admitted to hospital with ABI-related diagnoses, coupled with the fact the majority of these people will survive, suggests an ever-increasing demand on support services” (Headway May 2015)

NHS England has welcomed the findings of an independent audit that shows 20 per cent more patients are now surviving severe trauma since the introduction of Major Trauma Networks in 2010 and Results from the Trauma Audit and Research Network (TARN) national audit show that 1 in 5 patients who would have died before the networks are now surviving severe injuries.

So the need was identified and the process began: fact finding, networking, learning and research.

Jules and Toria spoke with numerous personal injury solicitors, case managers, insurance companies and NHS commissioners, as well as specialist medical consultants, patients and their families. When distilled, the the need was clear for a young, complex trauma/neurological and orthopaedic rehabilitation centre for adults over the age of 18 was clear and STEPS was born.