Leading across boundaries: establishment of the UCLH community outreach intrathecal baclofen refill service.

Abstract

Intrathecal baclofen (ITB) is a recognised treatment for severe spasticity. ITB users need to attend a specialist clinic regularly for their pump to be refilled and reprogrammed. Many patients travel significant distances and require hospital transport which is inconvenient, stressful and costly. These challenges inspired the University College London Hospitals (UCLH) spasticity team to explore establishing a community outreach clinic, staffed by the UCLH team, to provide care closer to home for this complex group. By mapping the patient cohort, using their general practitioner postcode, we identified patient clusters including those in the same long-term care facilities. In tandem, accessible healthcare locations within North Central London were identified and approached. The UCLH ITB outreach service was launched in December 2022. Over the next 15 months a total of six sites were established. In 2024, over a 12 month period, 28 outreach clinics were completed, with a total of 125 patients assessed and pumps refilled in the community. Transport and healthcare cost savings were realised, and patients reported positive, practical and emotional benefits. This initiative improved patient care as well as creating a local strategy for joint working through forging new relationships and embracing shared learning.