C-7 obtaining rehabilitation funding
Rehabilitation has never been resourced appropriately, so obtaining additional rehabilitation funding is vital. Quite apart from its low priority, many organisations are responsible for the resources a patient requires. There must be a collaboration or agreed system for arranging funding across different funders. Consequently, most rehabilitation services identify who might fund essential equipment or support, including long-term care, and then negotiate complex application processes. Very large rehabilitation services may employ a dedicated manager to resolve this problem. Usually, responsibility rests with the rehabilitation team. All team members need expertise in obtaining funds because the resource is typically related to a particular profession, such as a speech and language therapist applying for special communications aids.
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The competency is ...
The rehabilitation profession is “Able to identify and, if needed, access and use funding streams available for the disability-related needs of rehabilitation patients.” The two vital actions are discovering the appropriate funding source and completing the application process, which is often unnecessarily complicated. A document summarising the expected behaviours, knowledge and skills can be downloaded.
Why is obtaining rehabilitation funding necessary?
This competency is vital because there is no overall system for organising and funding rehabilitation. Consequently, most patients with significant long-lasting difficulties will need specific additional resources requiring a funding application. Most professionals may feel that obtaining funds is outside their remit, but their patients and their service will suffer unless they participate actively. Further, the fund applications usually require clinical information and justification only the involved team member can provide.
I have identified the underlying reasons for the problem elsewhere on this site, in pages and blog posts. In summary:
- Rehabilitation is holistic and works with the biopsychosocial model of illness.
- Holism requires attention to all systems affecting a person’s life, and these mainly include:
- Social Services
- Employment services and employers
- All financial disability and sickness support resources
- Equipment and adaptation services
- Each of these:
- Are separate administratively and financially
- Have their priorities which will differ, one from another
- Have different processes for anyone wanting their assistance
- Usually have further individual subsystems within them
Once the team has identified a resource needed that they do not have, this competency comes into play. Often the challenges and complexity make negotiating a labyrinth in the dark seem easy.
The first step is identifying the organisations or agencies that might provide the resources or funding. A suitable funder must also be found if a resource provider differs from the funding agency.
The next step is to negotiate around the funding application. This is rarely straightforward, with obstacles such as initial, preliminary applications or detailed assessment from another person or agency being required.
Third, the funders may come back with further questions or suggest an alternative funding stream, further delaying the process. Sometimes you may need to appeal the initial decision.
Rehabilitation funding sources.
I cannot comprehensively list all possible funding sources, even for the UK! I will suggest some general headings to consider.
The state provides funds for many aspects of a patient’s rehabilitation. The UK government lists some of the many grants: Benefits and financial support if you’re disabled or have a health condition.
Within health care, the NHS, through a Byzantine network of different funding streams, does support both general services and specific support for individual patients. Examples include Continuing Healthcare funding to pay for long-term care needed, Individual Funding Requests for specialist treatment, Personal Independence Payment giving money to pay for support, and Attendance Allowance to pay someone for providing care. There are websites to help you negotiate the system, such as the NHS site.
Many other statutory organisations can contribute, depending on the person’s needs. The Department of Work and Pensions have grants to help disabled people with work. Social Services can contribute to changes you a person’s home through Disabled Facilities Grants. Students in education may be supported with a disabled student’s allowance.
The non-statutory sector is another invaluable source of resources. There is a UK register of charities supporting people with disabilities, CharityChoice. On February 24th 2023, there were 721 charities listed!
Before looking through a register or searching, one can consider which type of charity will most likely help. This requires you to consider the patient’s circumstances and needs and select the most appropriate target organisation. For example, one may search for the following:
- a condition-specific charity such as the motor neurone disease association often has invaluable services
- a charity associated with the person’s career and work, such as the Royal Air Force Benevolent Fund.
- A charity associated with the impairment, such as Ataxia UK.
- A charity supporting disabled people in a specific way, such as the Calvert Trust supporting holidays
Becoming competent in obtaining rehabilitation funding.
This competency is unusual because there is no academic or research base to draw on, and it cannot be learned through academic study. It is a practical competency, only learned through direct experience and practice.
It is also a competency that depends more on the work context than most. The central, generic competency is searching the internet effectively and efficiently, using a systematic approach based on the four groups mentioned earlier. However, many invaluable sources are targeted at a specific group of patients based on the donor’s interests. Some are centred on people living in a locality, others on some characteristic valued by a philanthropist often in the Victoria era, such as single women “in service” or working in a trade that no longer exists.
As a trainee, you should talk to anyone looking for or applying for resources to learn about available sources and how they found the resource they are using. You should also help make applications to familiarise yourself with the process and help anyone in the team looking for resources.
The competency of obtaining rehabilitation funding is crucial for your patients and unusual among competencies because it can only be learned as part of daily clinical work, learning from others. The knowledge acquired is often quite specific to the locality you work in and your field of rehabilitation. The main skill needed is searching the internet, which everyone needs for all parts of their life, not just work.