This guideline covers complex rehabilitation needs after traumatic injury, including assessment and goal setting, rehabilitation plans and programmes, physical, psychological and cognitive rehabilitation, rehabilitation for specific injuries, coordination of rehabilitation in hospital, at discharge and in the community, and commissioning and organising rehabilitation services.
Traumatic injury is any major or minor injury that requires admission to hospital at the time of injury, including musculoskeletal, visceral and nerve injuries, soft tissue damage, spinal injury, limb reconstruction and limb loss.
The recommendations apply to all people with complex rehabilitation needs after a traumatic injury, unless a recommendation or section heading specifically states that it is for adults or children and young people only, or for people with a specific injury.
This guideline includes recommendations on:
- initial assessment and early interventions for people with complex rehabilitation needs
- multidisciplinary team rehabilitation needs assessment
- setting rehabilitation goals
- developing a rehabilitation plan and making referrals
- rehabilitation programmes of therapies and treatments
- principles for sharing information and involving family and carers
- coordination of rehabilitation care in hospital
- coordination of rehabilitation care at discharge
- supporting access and participation in education, work and community (adjustment and goal settings)
- commissioning and organisation of rehabilitation services
Rehabilitation therapies and interventions:
Injury-specific sections (to be read together with the rehabilitation therapies and interventions sections):
- rehabilitation after limb reconstruction, limb loss or amputation
- rehabilitation after spinal cord injury
- rehabilitation after nerve injury
- rehabilitation after chest injury
Who is it for?
- Healthcare professionals
- Social care practitioners
- Commissioners and providers of rehabilitation services
- Members of the public who have experienced traumatic injury, their families and carers
Guideline development process
This guideline was developed by the National Guideline Alliance, which is hosted by the Royal College of Obstetricians and Gynaecologists (RCOG). The guideline was developed with complete independence from RCOG governance.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.