Rehabilitation is no-one’s responsibility. This is true in many ways. There is no profession of ‘rehabilitation’; there is no UK national organisation representing rehabilitation; in health services, everyone supports it – but it is no-one’s priority; patients will by familiar with professionals who signpost them to services but do not provide them.
The main purpose of this site is to achieve a UK national organisation that is officially recognised as representing rehabilitation, not as part of some greater responsibility, not as a conglomeration of different organisation ‘with an interest’ but as an area of professional and clinical expertise in its own right. The organisation is needed to:
- represent all services delivering rehabilitation at all levels of health service organisation from the Department of Health and Social Care to the local general practice;
- advocate for service development and improvement in all geographic areas, and in all services and provider organisations;
- develop and validate professional qualifications so that members of any profession can demonstrate that they are also expert at rehabilitation in addition to their professional expertise;
- advocate for true multi-disciplinary high quality academic departments in all major universities and hospitals providing undergraduate teaching to students of any healthcare profession;
- advocate for true patient-centred and holistic healthcare services, and a culture that pays more that lip-service towards supporting and enabling people with long-term conditions to live as independently as possible;
Why is this necessary?
The public have little awareness or understanding of rehabilitation. Many people, perhaps most people do not really know what rehabilitation is. What could they expect when referred ‘for rehabilitation’? Who should, or should not be referred ‘for rehabilitation’? Was it only for people with drug and alcohol problems? Or people in prison? How would you know whether the person or service knew what they were doing?
Within the healthcare system, rehabilitation has a low priority. This may well be precisely because no-one really knows what it is. Commissioners do not know what they are getting, or why they should pay. Patients do not know what they are missing, and so do not campaign for it. Healthcare professionals with power and influence cannot see any reason to support rehabilitation in preference to their own speciality. This especially applies to education and training. Doctors, surprisingly, are the only profession with specialist training in rehabilitation. It is surprising because rehabilitation has very little resource devoted to it in under-graduate or early postgraduate education and training.
There is, currently, no national (to the UK) organisation promoting rehabilitation. Indeed only two national organisations devoted to rehabilitation are known to me. The Society for Research in Rehabilitation is a truly multidisciplinary organisation, focused on rehabilitation, founded in 1978 and still going strong. The British Society of Rehabilitation Medicine is the only other one but, although other professions can now join, it is at present primarily a doctors society.
As a consequence, access to expert rehabilitation is limited. This is accompanied by considerable inequity between different conditions, between different areas, and between different socio-economic groups (and, doubtless, different ethnic groups). The quality of services offered is patchy, with many services not offering full rehabilitation. Although the best services are undoubtedly good, much that is labelled as rehabilitation offers an incomplete rehabilitation service, with no true multi-disciplinary team and lacking essential professional and treatment resources.
One aim of this website is to improve the rehabilitation services offered to patients in two ways: increasing access to services; and increasing the quality of the services.
Why should the NHS care?
The UK NHS constitution, published in 2012, said:
The NHS belongs to the people.The NHS Constitution. the NHS belongs to us al. 8 March 2012. (see here)
It is there to improve our health and well-being, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end
of our lives.”
Rehabilitation is essential to achieve the second purpose: “… and, when we cannot fully recover, to stay as well as we can to the end of our lives.” For rehabilitation to help the very many patients who ‘cannot fully recover’, and also the group who have losses from birth, the NHS needs a focused rehabilitation service in which all staff have specific expertise in rehabilitation in addition to their professional expertise. At present only doctors have specific training in rehabilitation.
Therefore, one of the objectives of the site is to explain, advocate for, promote, improve access to, and generally raise awareness of rehabilitation as a healthcare activity that requires specific expertise over and above the specific professional expertise of the healthcare professions involved. This site is independent of any specific profession, and will encourage the development of rehabilitation knowledge and skills across all professions.
A second aim is to stimulate and facilitate a national organisation whose purpose is to promote specialist training in rehabilitation for clinicians from any profession, eventually to validate both the training programmes and the achievement of expertise.
Why should you care?
Almost everyone will, at some point, probably need some rehabilitation, and everyone will certainly know someone who could benefit from it. Therefore rehabilitation matters to everyone:
- to patients with long-term health problems;
- to families living with some who is disabled;
- to employers who have an employee with a disability;
- to care homes, because all their patients have a some disability;
- to all organisation in healthcare, because;
- most inpatients and many outpatients have significant disabilities;
- rehabilitation can reduce long-term health and social care costs;
- to society who bear the costs of caring for people with a disability;
and most of all
- to you the reader, who will one day need rehabilitation whether you know it or not.
How will this site help?
This site introduces readers to some of the large range of information, ideas, debates and uncertainties relating to rehabilitation. In other words, it covers rehabilitation matters:
- scientific information, covering many different disciplines from social sciences to neurophysiology;
- theories underlying the processes involved in rehabilitation;
- philosophical ideas relating to the nature of illness and health;
- practical information concerning treatments, care, resources etc;
- discussion of service design and delivery;
- sources of further information;
- training in rehabilitation;
- blogs, and (eventually) much more.
In summary, I hope that in ten years’ time, we will always know who is responsible for rehabilitation, whether in providing a service, paying for a service, monitoring the quality of professional rehabilitation practice, ensuring services meet quality standards or, most importantly of all, ensuring that each patient needing rehabilitation receives it.