Tackling variation in rehab for people with neurological conditions
NICE has recommended a standardised approach for rehabilitation, to address the variation of care experienced by millions of people with chronic neurological conditions.
In a new guideline published today, NICE recommends a standard, holistic approach to rehabilitation to address the wide variation in the delivery of treatment.
The guideline covers five major categories of neurological conditions:
brain and spinal cord injuries
peripheral nerve disorders
progressive neurological diseases
functional neurological disorders.
It includes people who have been discharged from health care and not receiving consistent or adequate rehabilitation support, despite ongoing needs.
A significant number of people live with the long-term consequences of neurological disease and disorders. Estimates suggest that around 1.3 million are living with the effects of a traumatic brain injury alone.
To ensure consistency of care, the guideline recommends for there to be a single point of contact for people with chronic neurological disorders. This includes ensuring there are complex case managers within each of the 42 integrated care boards in England.
These specialists would co-ordinate care across health, social care, and third-sector organisations. This will help ensure people receive the rehabilitation services they need.
Without consistent rehabilitation support, people can experience unnecessary decline in their condition and quality of life. This new guideline will help ensure people living with these chronic conditions get the ongoing rehabilitation care and support they need to improve their health and wellbeing.
Yvonne Pettigrew, a NICE committee member with lived experience of a chronic neurological disease said, "Coordinated rehabilitation can help make the most of someone's abilities, even when there's a time-limited prognosis, or the potential for improvement appears to be limited.
"With the help of this guideline, service users can expect their GPs and other health and social care practitioners to recognise and understand their rehabilitation needs and be guided as to when and how to refer to rehabilitation specialists.
"One of the most significant recommendations in this guideline for me is that each service user is always to have someone they can contact for guidance or assistance; their 'key contact', 'key worker' or 'case manager'. This contact is likely to change over time, but everyone with a chronic condition can expect to have this assistance, all through their journey."
As someone with a traumatic brain injury I know first-hand how difficult it can be living with a chronic neurological condition, and the challenges that can arise in accessing appropriate services.
Sue added, “This guidance makes a difference through highlighting the critical importance of providing an integrated, comprehensive and co-ordinated approach to rehabilitation that can support a person to live as well as possible with their condition.
"The introduction of a single point of contact, and the recognition of providing appropriate support in all areas from activities of daily living to education, employment and social engagement, will make a positive difference to us all.”
The guideline sets out the rehabilitation therapies, activities, training, education and other interventions and support. These enable people with chronic neurological conditions to live better, healthier and more independent lives for longer. The guideline also includes recommendations for improving assessment and referral pathways.