Specialist rehabilitation for patients with complex needs following major injury report 2016
This report presents the outputs from the work in the first year of the NCASRI programme. It describes the current level of provision of specialist rehabilitation within the Major Trauma Networks based on the results of a survey and on retrospective analyses of existing data – including rehabilitation data collected in the Trauma Audit and Research Network (TARN) database and the UK Rehabilitation Outcomes Collaborative (UKROC). The report explores the pathways of care and examines clinical practice – how patients that may require specialist rehabilitation are identified, where they receive that care, how long they wait and several other important criteria.
Key findings include:
- The current capacity within in-patient specialist rehabilitation services caters for about 950 patients per year – which is about 5% of the adults admitted to major trauma centres following major trauma
- Provision is varied considerably across the country, ranging from 1 to 8 beds for adult trauma patients per million population
- Within the specialist rehabilitation services, under-commissioning was a significant problem. In comparison with national standards, between half and two-thirds of the specialist rehabilitation units had insufficient staffing to manage a complex caseload
- Less than three quarters of patients had cost efficiency data available. These data are important to continue justifying the effectiveness of specialist rehabilitation
- Involvement of Rehabilitation Medicine (RM) consultants within the major trauma centres (MTCs) also varied.
- Some networks funded sessions and had up to 6 RM consultants working in major trauma, while 18% of the centres had no RM consultant input at all
- Provision was particularly poor in London where there was only one MTC-funded session for an RM consultant across the 4 large networks in London
- Only half of the major trauma networks currently use a specialist rehabilitation prescription to direct the care for patients with complex needs after they leave the MTCs
The full report is available to download below
