“…to ensure the maximum recovery of patients, the maximisation of their potential and their reintegration into the community. …The message is loud and clear: the Rehabilitation Hospital seeks to rehabilitate the patient and the goal is NOT to exclusively provide care simply until residential care services can accommodate the patient.”

As one has been able to follow in the media, Zammit Clapp Hospital migrated to Karen Grech Hospital on 10 and 11 May. This means that all services are now being provided from one place, the Rehabilitation Hospital: Karen Grech in Pietà. But what does this migration actually mean to the public?

First of all, what does the word ‘rehabilitation’ mean? Rehabili-tation is concerned with the

prevention, diagnosis and

management of people of all ages with disabling conditions and co-morbidity. Following the acute management of various pathologies and events such as stroke, amputation or trauma, rehabilitation involves the managing of a patient by an interdisciplinary team consisting of various professional and non-professional members of staff. Together, the team comprehensively tries to ensure the maximum recovery of patients, the maximisation of their potential and their re-integratration in the community, away from acute and residential care services.

Is this completely new to Malta? No, it is not, because in 1991 a Geriatric Department was set up in order to deal with problems specifically related to the elderly, including their rehabilitation. Since 1991, patients over the age of 60 have been offered optimal geriatric care, including rehabilitation at Zammit Clapp Hospital. Many members of the public have directly experienced the success of this initiative over the years. However, despite its success, the provision of care to all patients needing rehabilitation remained a significant challenge.

Where was the patient who was under 60 to receive rehabilitation? The unfavourable scenario of patients under 60, unable to go home and having to remain within the acute care services until they were sufficiently independent to go home, persisted – perhaps increased – over the years. This scenario fell short of the efficient use of acute care beds and, moreover, it fell short of addressing the rights of young patients to optimal rehabilitation.

The opening of Mater Dei Hospital in November 2007 was a turning point. A number of wards in Karen Grech Hospital were refurbished to accommodate geriatric patients and it is important to note that one of these wards specifically accommodates patients under the age of 60. This ward constitutes a milestone in the development of the provision of rehabilitation services in Malta. It has widened the field of National Rehabilitation Services to what it should be – the treatment of patients of all ages.

As with any other initiatives and changes, this “new” expanded and widened concept of rehabilitation for people of all ages needs to be explained and subsequently endorsed by the public and, indeed, also by the service providers – the health and social care workforce included.

This is no small order, but one can now note a significant acknowledgement of the concept of new non-geriatric in-patient rehabilitation.

Now, following the Zammit Clapp migration, we will see the aggregation of staff dealing with rehabilitation, whether geriatric or non-geriatric, in one place – The Rehabilitation Hospital, Karen Grech. This hospital will now cater for all the rehabilitation needs of patients with various pathologies, both on an in-patient and out-patient basis, and from the age of 16 upwards, thus offering a wider service in this respect. This extended and expanded service is possible through the engagement, over the past few years, of more consultant geriatricians, a consultant in rehabilitation medicine and various other professionals with relevant expertise.

Much effort is being channelled towards moving away from the perception that the Rehabilitation Hospital offers basically long-term care to patients waiting to be admitted to residential care services for the elderly. The message is loud and clear: the hospital seeks to rehabilitate the patient, and the goal is NOT to exclusively provide care simply until residential care services can accommodate the patient, although some patients might, nonetheless, need to be admitted to a residential home following a period of rehabilitation services provision.

It is hoped that the integration and extension of the rehabilitation services into the newly established Rehabilitation Hospital, Karen Grech, will result in not only the continuation of the excellent service that Zammit Clapp Hospital provided to the elderly, but also the development of a comprehensive hub of rehabilitation services, comprising the development of extensive in and outpatient services, in conjunction with outreach and community services, for all adults, of all ages.

This is the plan – this is the right of the public – this is believed to be the correct way forward. Let us all try to implement this plan: the ball seems to have started to roll – in the right direction.

Dr Portelli is the president of the PN Executive Council

[email protected]