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.
A patient’s father recently asked me, “What is the usual rehabilitation curriculum for someone with problems like my son’s?”. Until then, I had only considered a rehabilitation curriculum in the context of educating and training healthcare professionals about rehabilitation. I had never thought of a patient’s rehabilitation curriculum. Although I have often said rehabilitation is …
The Community Rehabilitation Alliance recently published some Best Practice Standards for rehabilitation aimed at the newly founded NHS Integrated Care Boards that manage the Integrated Care System. It recommended the formation of a rehabilitation network, and the standards applied to the network were set out and summarised in tables. I have abstracted them into a …
Rehabilitation networks are the central theme of the recently published Rehab on Track. Community Rehabilitation Best Practice Standards. Its second recommendation is to “establish a local provider rehabilitation network to include primary, secondary, tertiary health care, mental health, social care, independent and third sector providers”. Moreover, its following recommendation is to “review existing rehabilitation services …
At a recent meeting in Genoa of RIMS (Rehabilitation in Multiple Sclerosis), Dr Carlotte Kiekens discussed the leadership of the rehabilitation team, providing some challenging evidence and ideas to consider. In this blog post, I will review the whole question of leadership in rehabilitation. Traditionally doctors have considered themselves the leader, which is still the …
Over the years, I have heard people advocating strongly for specialist rehabilitation services for people with stroke, multiple sclerosis, traumatic brain injury, motor neurone disease, Huntington’s disorder, and many other specific diseases. I have also heard people advocating specialist services for people with behavioural disorders (whatever that might be), memory and cognitive disorders, chronic pain, …
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, …
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