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The best way of caring for brain-injured adults from the time of their injury to the end of their lives is to be spelled out in a strategy being developed by ACC.
Corporation national serious injury service manager Liz Cairns said the aim of the strategy was to ensure the care provided to the moderate and severely brain-injured wherever they lived in the country was consistent, rapid and appropriate.
Asked if there were wildly differing types of care provided now, Ms Cairns said she would not describe it that way, but best practice elsewhere showed other places had more clearly defined protocols.
The biggest group of the 3000 brain-injured adults throughout the country was "sadly" young men aged 16 to 20.
They had a long time to live with the consequences of their brain injury.
The life-time cost for care for a brain-injured adult was about $8 million, but that cost did not take into account the social or family impact.
Ms Cairns emphasised the strategy was not about cutting costs, acknowledging that it could turn out to cost more, particularly at some stages of treatment.
Research showed that whatever was done in the early stages after injury had a significant effect on the quality of life eventually achieved by patients.
It might prove to be necessary to spend "more up front".
The strategy would be developed in conjunction with families, those with brain injuries and health services.
There was agreement all involved needed to be "on the same page" to make sure clients were getting what they needed in the right way at the right time, she said.
Consultation with families and clients had not yet begun, but it was hoped the draft strategy would be completed later this year.
It was not expected it would be made public until next year, after feedback had been received on it. Once in place it would be reviewed regularly.
The strategy will not apply to adults with mild brain injury, such as concussion, or children where a different set of treatment protocols applied.
The ISIS centre at Wakari Hospital will be one of the services providing input into the strategy.
The centre's inpatient rehabilitation contract, along with a number of contracts involving other health services, will expire in June next year and will go out for tender before that date.
ACC specialist rehabilitation category manager Claire Stearne said the new strategy would influence what the new contract covered.
In response to Otago Daily Times questions, she said ACC had no issues with the existing contract with the centre - "in fact we think the centre is an excellent provider which provides an important service for those of our clients with traumatic brain injuries".
She said ACC clients made up less than 25% of the ISIS centre's patients.
In July, Southern District Health Board's mental health and community services general manager Elaine Chisnall advised there were "some issues" under consideration at the centre, but would not elaborate.
Her response followed concerns raised by a patient about the future of respite care services.
Mrs Chisnall confirmed respite care was one of the areas under discussion.
In early August, Mrs Chisnall advised it was too early to give any further information and another inquiry earlier this month has not yet drawn a response.