Posts in this category discuss some aspect of service design, delivery or change. Most will relate to the UK, unsurprisingly, but it is probable that similar considerations and issues arise in most countries.
What is slow-stream rehabilitation? Dr John Burn is leading a group in writing guidance and standards for nursing homes (care home, skilled nursing facilities) that undertake rehabilitation for some or all residents. This will update guidance from 2013. We recently debated whether slow-stream rehabilitation was an appropriate term to use within the guidance. I argued …
Hospitals are a part of the healthcare system, but is rehabilitation healthcare? The UK Department of Health, responsible for all healthcare and not just hospitals, promotes the idea that a patient only has a right to reside in a hospital until specific criteria are met. The requirements are mainly physiological and do not consider the …
In 2007 Peter Halligan and I asked, “Is it time to rehabilitate convalescence?”. No one answered until, in 2022, Gavin Francis also challenged healthcare practice in his book, “Recovery, the lost art of convalescence.” He argues that “from time to time, we all need to learn the art of convalescence”. The medical literature, however, publishes …
In 1980 I started a three-year project, a large (n = 700+) controlled clinical trial investigating whether a community stroke rehabilitation team would reduce the use of hospital resources. My results found no effect. Twenty years later, I was still interested in community rehabilitation and, with Pam Enderby, published the results of a survey she …
What is a person’s ‘Rehabilitation Potential’? Often this question is asked by one clinician of another about a patient. Still, there is a second interpretation, “What do we mean by Rehabilitation Potential when we ask that question?” I will discuss these questions, but before doing so, I will consider two further crucial questions, “Can we, …
This blog post is based on an extensive systematic review that generated a sound, theoretically-based model of person-centred rehabilitation. I can only develop some central themes and messages here. For more details, read the article. (here) The authors conclude that person-centred rehabilitation “is a way of thinking about and providing rehabilitation services “with” the person.” …
Is this patient ready for discharge? This question must be asked endlessly by care staff, managers, and sometimes the patient themselves. In this blog post, I will argue that it is the wrong question and that, by asking the wrong question without thought, we are failing to provide the best care to our patients. Moreover, …
Rehabilitation usually promotes itself as holistic, considering the patient as a whole and being patient-centred. Using the biopsychosocial model should indeed enforce a holistic, patient-centred approach. (here) Nevertheless, there are counter-forces at play, forces that we sometimes encourage. The primary countervailing power is a desire to categorise, classify, and develop small specialise treatment programmes. For …
Teams use many different words to describe themselves. A group recently asked me to help them decide whether they are a multidisciplinary or an interdisciplinary team. The background information provided perfectly illustrated the difficulty in defining the team, as illustrated in this figure. (here) The question prompted me to write this blog post to show …
Multidisciplinary, Interdisciplinary, or Transdisciplinary? Read More »
Today, 18th July 2021, the UK National Institute for Health Research (NIHR), one of the major health research funding bodies in the UK announced £19.6M had been allocated to research into the late effects of Covid-19 infection (here), commonly known as Long Covid. This is in addition to £18.5 million allocated in February (here), funding …
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