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.
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 team 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 …
One Friday 2nd July 2021 (at 05.00 hrs) I took part in a debate organised by Professor Barbara Wilson and hosted, virtually, in Melbourne, Australia. The debate concerned the use of goal attainment scaling (GAS). Two speakers supported its use clinically, in audit, and in research and two speakers opposed its use. At the outset …
One December 18th 2020 the UK National Institute for Health and Clinical Excellence (NICE) published its guidance on managing the long-term effects of COVID-19. (here) On re-reading it, they are in reality suggesting that everyone should have access to “integrated, multidisciplinary rehabilitation services“. They also state (correctly) that one cannot know who has actually had …
Two incidents precipitated this blog. During discussion after a talk on an evidence-based definition of rehabilitation (e.g. as here), I was asked whether services provided by Social Services (and others) could also be considered as providing rehabilitation. My reply was that rehabilitation is a process and, as its intended outcomes relate to social participation, and …
This blog reviews a recent policy document from NHS England, which aims to introduce expert medical and rehabilitation services, including mental health and palliative care services, into all nursing and care homes. This blog reviews the proposal, showing how it could be simplified and used to provide accessible, expert rehabilitation services not only into care …
This is a true incident. A friend of mine is helping out as a physiotherapist during this pandemic. Recently, in order to get a patient who had just been discharged from the hospital seen, she had to spend nearly three hours inputing three different sets of referral data, all covering the same basic information, into …
Medical services responded rapidly to the very obvious, severe acute challenge of increasing numbers of people severely ill with Covid-19. The challenge to rehabilitation services is likely to be ten times as big, given that long-covid arises after less severe acute illness as well as after severe illness. Yet, despite the longer lead time which …
The word, specialist, when preceding rehabilitation, concerns me. The natural corollary of adding the adjective is that there must be some other type of rehabilitation. What is that type? I will explore four aspects of specialisation (1-4), consider why the word is used (5), and then draw two conclusions (6, 7). The structure of this …
