Community rehabilitation

When we talk about the National Health Service it is all too easy to think of some large and impersonal entity. But talk to any individual and they are far more likely to talk about ‘my doctor,’ ‘my local hospital,’ ‘my physiotherapist.’ And that quasi-one-to-one relationship sits at the heart of delivering effective healthcare.

The need for a more personalised local response runs strongly through the Chartered Society of Physiotherapy’s (CSP) community rehabilitation plan. First launched in October 2022, the plan has hit the headlines more recently with a version being launched in Northern Ireland at the beginning of May 2023. The plan opens with a simple statement:  

Rehabilitation makes people’s lives better. Many of those who would most benefit from rehabilitation, however, face barriers to accessing services.”

Those barriers can lead people to come back time and time again to require core NHS services rather than being supported in a more appropriate way. For some individuals that support may come from Social Services, whilst others may be better helped vial community hospitals or care homes, or through the provision of physiotherapy, occupational therapy or other interventions.

Importantly, delivering community rehabilitation in this way not only reduces the demand for NHS in-patient services but also can improve the lives of individuals; helping them to live with, manage, or improve their conditions. But for community rehabilitation to work the CSP recommends that it is delivered as an integral part of an integrated care system (ICS) which looks to “include primary, secondary, tertiary health care, mental health, social care, independent and third sector providers.” 

Underpinning the delivery of an effective community rehabilitation plan, the CSP recommends that:

  • Referral processes are explicit, easy, efficient and equitable
  • Rehabilitation interventions are timely, co-ordinated and prevent avoidable disability
  • Rehabilitation interventions meet patient needs and are delivered in an appropriate format
  • Rehabilitation pathways should meet needs and be delivered locally with access to specialist services
  • Rehabilitation Programmes should enable optimisation, self-management and review
  • Rehabilitation services are well led, adequately resourced and networked to other services
  • Rehabilitation Services involve Families

That desire to involve families and local providers in the delivery of coordinated rehabilitation demonstrates the importance of localised and personal health delivery which is tailored to the individual. Importantly it also draws in all providers of health services into an integrated patient-centric network. It’s one reason why the use of technology is revolutionising health delivery. Even something as simple as the ability to digitise patient notes helps with the sharing of information across organisations. This not only helps to speed up referrals but also to provide a more targeted treatment plan, particularly in those who may need multi-disciplinary treatments.

At the Northern Ireland launch of the community rehabilitation plan Marie-Therse McDonald, CSP professional adviser for Northern Ireland said: “Without access to high quality community-based rehab, people will continue to be driven towards the most expensive parts of the health and social care system.” She went on to add “We know that what tends to work is care close to home, person centred, specialist, integrated and supports self-management principles.’”