British Society of Physical and Rehabilitation Medicine
Date published:
Date Last updated:
February 8,2025
The British Society of Physical and Rehabilitation Medicine, the BSPRM, is the primary UK organisation for doctors interested in rehabilitation, especially but not exclusively doctors trained in Rehabilitation Medicine. Until 2022, it was the British Society of Rehabilitation Medicine, and it changed its name after a vote of all members. It welcomes other people from other professions as associate members. Although most members are doctors, the Society has produced many reports and documents concerning rehabilitation in general, and they are available here. This page outlines the UK’s rehabilitation history and how Society developed. It then describes the Society before reviewing how it can contribute to a National Rehabilitation Community. In 2023, the BSPRM and NHS-E (NHS England) formed the Clinical Post COVID Society as a joint initiative; NHS-E provided initial funding, and the BSPRM runs the Society as a working group. This is an example of how the BSPRM could become the leading multiprofessional rehabilitation organisation within the UK.
Table of Contents
Introduction
Every healthcare speciality has an organisation, usually a charity, representing its interests and supporting education and professional standards. Historically, doctors have founded most of these institutions, but the societies or associations are increasingly multiprofessional. Some professional groups have two or three organisations, and individuals may belong to several.
These professional organisations are influential because politicians, policymakers, health departments, and other healthcare organisations rarely employ experts in recognised specialities. They also determine professional and service standards, advise research bodies, and more.
In the UK, rehabilitation did not have a politically-active specialist society until 1984. Before that, it was subsumed into a rheumatological society. The Society for Research in Rehabilitation was founded in 1978 as a multiprofessional society, but its main concern remained research. Rehabilitation only became a recognised speciality in 1994.
History of the BSPRM
Thomas JA Terlouw reviewed the explicit use of exercise, massage and similar physical treatments for health reasons, which started in the mid-nineteenth century in continental Europe, and related it to inter-professional rivalry that delayed the emergence of rehabilitation research and services in the Netherlands. The First World War precipitated a much greater interest in reducing disability after injuries, with a continuing focus on exercise and activity with additional electrotherapy as undertaken at the Bath War Hospital, probably one of the first explicit rehabilitation units in the UK. It did not lead to the development of a specialty in the UK.
After the Great War, interest in rehabilitation continued and grew. It was known as ‘physical medicine’, and the early articles were published in the Journal of Radiology because radiation had become another therapy. That journal evolved into the Archives of Physical Medicine and Rehabilitation. I am unaware of any UK journals publishing rehabilitation materials at that time.
The American Society of Physical Therapy Physicians, founded in 1938, was probably the world’s first specialist society. Its status was formally recognised in 1939; it had 40 members. In 1955, it became the American Academy of Physical Medicine and Rehabilitation. It now has more than 9,000 members.
Physical Medicine only covers some disabling problems because the treatments involved (exercise and physical, hands-on therapies) cannot resolve a proportion of the difficulties faced by people with disabilities, for example, urinary incontinence or forgetfulness.
Rehabilitation has a much broader scope than Physical Medicine. Alan Barton and Graham Mulley suggest Marjorie Warren was probably the first doctor to practice rehabilitation in the UK; she was a physician caring for older people. This branch of rehabilitation focused on older patients, culminating in the speciality of geriatrics. For many years, geriatric services for the elderly were the mainstay of rehabilitation in the UK. Geriatricians and their teams led much original research into rehabilitation after strokes, falls, and fractures. Rehabilitation expertise still forms a significant component of training to be a geriatrician.
The first specialist Society for Rehabilitation formed in the UK was the British Association of Physical Medicine, founded in 1943. The founding members developed their practices and ideas following the First World War. The Association was “founded as the professional body to promote and firmly establish the speciality of Physical Medicine amongst physicians.” The membership was restricted to doctors, partly to distinguish it from physiotherapy. W S Tegner, a founding member, wrote a short history of the association.
The British Association of Physical Medicine held its first meeting outside London in 1956. In 1968, it had a meeting at King’s College Hospital, London. The talks at this meeting included:
- A report on a double-blind controlled trial of physiotherapy exercises for people with backache (Dr P Hume Kendall)
- an estimate of the prevalence of disability from Dr George Cochrane
- a discussion on rehabilitation for people with severe mental health problems
- a talk from Dr J C Brocklehurst, a well-known geriatrician on rehabilitation in the elderly
- a talk from Dame Cicely Saunders, who made two notable statements. Terminal care is the care of “the state that commences when somebody else said that there was nothing further to be done.” and that “patients should die peacefully but, until that time, they should live fully.”
This meeting showed that the Association took a broad view of rehabilitation, encompassing mental illness, the elderly, end-of-life and palliative care, and musculoskeletal problems. This was lost for years; for example, when I started in 1980, people aged 65 were explicitly excluded. It also showed an early understanding that randomised, controlled studies were necessary and feasible
In 1970, the Association added rheumatology to its name, becoming the British Association for Physical Medicine and Rheumatology registered as a charity in 1972. It later became the British Association for Rheumatology and Rehabilitation (BARR). These developments recognised the importance of rehabilitation for people with arthritis. The later arrival of specific treatments for inflammatory arthritis reduced the focus on rehabilitation until people took an interest in chronic musculoskeletal pain.
In 1983, the British Association for Rheumatology and Rehabilitation split. The rheumatology section merged with the Heberden Society to become the British Society for Rheumatology. The rehabilitation section formed the Medical Disability Society, founded in 1984. After a few years, it changed its name to the British Society of Rehabilitation Medicine (BSRM).
The recognised speciality of rehabilitation medicine started in 1993 with a limited scope, but the latest 2021 curriculum has revived the broad range of conditions covered in 1968.
In 2021, the BSRM debated adding the word “physical” to its name for about six months, culminating in a vote. The majority favoured the current name, the British Society of Physical and Rehabilitation Medicine.
In 2024, the BSPRM formed a joint venture with NHS England to set up a Clinical Post-COVID Society, an explicitly multi-professional working group within the BSPRM. It is funded for two years. This development provides an opportunity for the BSPRM to become a genuinely multiprofessional society representing all rehabilitation across the UK.
In 2024, we concluded the update of our constitution, which began in 2021. The constitution is available on the website. The BSPRM is a Charitable Incorporated Organisation with voting members other than its charity trustees, a much more flexible and up-to-date constitution than our previous one..
Comment on the history
This overview highlights some interesting and relevant points.
Most notably, when the Society was the British Association of Physical Medicine, it had a comprehensive and inclusive view of rehabilitation. It considered psychiatric rehabilitation, palliative care, and rehabilitation of frail older people to be important matters. The only significant area missing was paediatrics.
Equally, the Association recognised that research was crucial. The trial reported to the Association in 1968 must have been one of the first rehabilitation trials undertaken. There was also an interest in epidemiology and the services needed, again two vital aspects of rehabilitation science.
For the first 40 years, the specialist group, first as an Association and then as a Society, was closely associated with the term ‘physical’ and, latterly, with rheumatology.
Last, until recently, it remained a society for doctors; other professions could join after meeting seniority criteria but could not be full members. The addition of many people from many different professions to the COVID working party may precipitate a change in the Society, legitimising its role as the primary organisation representing rehabilitation, not just doctors.
BSPRM Publications.
The Society has published many guidelines, service standards, position statements, and other professional documents, a considerable number given its small membership. Most of them are still available on the web; they are classified into various types, which overlap.
They can be found in the “Guidelines and Standards” or “Essential Reading” sections on the BSPRM website. Alternatively, they are shown in the table below with links.
Estimating their effects is challenging. On the previous British Society of Rehabilitation Medicine (BSRM) website, they were the most frequently visited pages and many were downloaded.
The most recent guideline was on rehabilitation in nursing homes. We had many extensive debates in the working party about its scope, what rehabilitation is, how detailed it should be etc. John Burn steered the group well, and I feel the guideline is crucial in the current situation because rehabilitation is becoming disintegrated without any networks to maintain coherence and standards.
| Topic/link | Title | Type | Date | Information |
|---|---|---|---|---|
| Specialist community rehabilitation | 2021 BSRM Standards for specialist rehabilitation for community dwelling adults – update of 2002 standards | Standards | 2021 – Mar. | Provides the standards expected of services providing expert rehabilitation to patients with more severe or complex disability in a community setting. |
| Anti-depressant drugs and acquired brain injury | Use of antidepressant medication in adults undergoing recovery and rehabilitation following acquired brain injury | National Guidance | 2005 – Sep | Joint national guideline with Royal College of Physicians and British Geriatric Society on the use of anti-depressants in patients after acute brain injury (e.g. after stroke or traumatic brain injury) |
| Services and BSPRM | Proposal for expansion of rehabilitation medicine in the UK | Proposal | 2016 - Aug | A proposal developed by a group of members for the development of the speciality and the Society. |
| Nursing home care & rehabilitation | Specialist Nursing Home Care for People with Complex Neurological Disability: Guidance to Best Practice | Guidance & Standards | 2013 | Considers how to improve both care and rehabilitation in care homes that admit patients with complex disability and rehabilitation needs. Now replaced by 2024 guideline |
| Nursing home care and rehabilitation | Rehabilitation and Complex Disability Management in Specialist Nursing Homes and Other Residential Units: Guidance to Best Practice | Guidance and standards | 2024 | Sets out high-level capabilities and some individual competencies so that it covers the huge range of general and specialist rehabilitation services found in nursing homes and other non-NHS settings and organisations. |
| Mass casualty event | BSRM Position Statement on the response to a Mass Casualty Event (MCE) | Position paper | 2020 - Jan | Recommends how to meet the rehabilitation needs of people after a Mass Casualty Event, drawing on experience after an event |
| Acute phase rehabilitation | Rehabilitation for patients in the acute care pathway following severe disabling illness or injury: BSRM core standards for specialist rehabilitation | Standards | 2014 – Oct | Covers all acute-onset conditions and developed the pathway for patients needing rehabilitation now widely used in commissioning and planning services. Introduces Level I to III services. |
| Amputee and prosthetic rehabilitation | Amputee and Prosthetic Rehabilitation – Standards and Guidelines. 3rd Edition | Guidance & Standards | 2018 | Not only sets standards and gives guidance but also reviews history and evidence and sets everything in the broader contexts affecting amputee rehabilitation. |
| Cancer rehabilitation | Cancer Rehabilitation BSRM Position Paper | Position paper | 2019 - Nov | Reviews the current position in the UK and sets out proposed Core Standards for service development and provision. |
| Rehabilitation for patients with CPE | Framework for Action to contain carbapenemase-producing Enterobacteriacae (CPE) - application in rehabilitation | Position paper | 2021 – Jan | A response to the Public Health England Framework for Action for patients with carbapenemase-producing Enterobacteriacae (CPE) to optimise rehabilitation for these patients. |
| Complex regional pain syndrome | Complex regional pain syndrome in adults. UK guidelines for diagnosis, referral and management in primary and secondary care. 2nd edition | National guidance | 2018 | A national guideline developed by the Royal College of Physicians with many interested organisations including BSRM |
| Covid’s effect on rehabilitation. | Rehabilitation in the wake of Covid-19 - A phoenix from the ashes | Working document | 2020 – May | The last version on 11th May 2020 reviewed both effect of Covid on existing rehabilitation services and the profound implications of the rehabilitation needs of people after Covid infection. |
| Deprivation of Liberty safeguarding | Deprivation of Liberty in the Rehabilitation Setting | Position paper | 2017 - Feb | Discusses the implications of Deprivation of Liberty Safeguards for inpatient rehabilitation service |
| Technology and rehabilitation | Electronic Assistive Technology Report | Report | 2000 - Jul | Built on the report by the Audit Commission exposing the low number of services in the NHS providing assistive technology. Input from many organisations. |
| Rehabilitation services | Medical rehabilitation in 2011 and beyond | Report | 2010 - Nov | A joint report between the Royal College of Physicians and the British Society of Rehabilitation Medicine. It built on three earlier reports, specifying role of Rehabilitation Medicine in services. |
| Musculoskeletal rehabilitation | Musculoskeletal Rehabilitation. Report of a working party convened by the British Society of Rehabilitation Medicine | Report | 2004 - Sep | Reviewed UK NHS services both generally and for specific conditions, and made a series of specific recommendations concerning services and conditions. |
| Patient safety | Patient safety strategy for Rehabilitation Medicine | Strategy | 2021 - Feb | Set out five areas of patient safety concern arising within the NHS generally for patients with disability who might need rehabilitation input |
| Spasticity, botulinum toxin | Spasticity in adults: management using botulinum toxin. National guidelines 2018 | National guidance | 2018 | Joint national guideline with Royal College of Physicians, Chartered Society of Physiotherapists, Royal College of Occupational Therapists, including ACPIN |
| Wheelchairs | Specialised Wheelchair Seating National Clinical Guidelines | National guideline | 2004 - Apr | Multidisciplinary expert report commissioned by the BSRM to improve services providing specialised wheelchair seating in the UK NHS |
| Spinal cord injury | Chronic spinal cord injury: management of patients in acute hospital settings | National guideline | 2008 – Feb | Joint report by Royal College of Physicians and BSRM, BASCIS, MASCIP on the care in acute hospitals provided to people with long-term spinal cord injury, after admission with another condition. |
| Tracheostomy | Levels of nursing care and supervision for Trachy patients in rehabilitation and long-term care settings | Position paper | 2015 – Oct | Sets out requirement and clinical recommendations for patients with tracheostomies cared for outside hospital. Joint with NHS-E Clinical Reference Group |
| Vocational rehabilitation | Vocational Rehabilitation: BSRM brief guidance | Clinical guidance | 2021 - Aug | Aims at medical specialists involved in vocational rehabilitation |
| Neurorehabilitation service standards | Specialist Neuro-Rehabilitation Services: Providing for Patients with Complex Rehabilitation Needs | Service standards | 2023 -May | Gives standards for four categories of complexity and Levels I, II, III services, and costing information |
| Trauma rehabilitation pathway | Specialist Rehabilitation in the Trauma pathway: BSRM Core standards | Service standards | 2018 - Nov | Covers the complexity and other measures for trauma pathway, rehabilitation prescription, and core process standards |
| Palliative care position paper | The role of palliative care interventions for people living with long term neurological conditions | Position paper | 2022 – Oct | Covers all aspects of palliative care, including training, for patients with long term disabling conditions |
| Spinal injury rehabilitation | Standards for specialist rehabilitation of spinal cord injury | Service standards | 2022 – Sept | Jointly with NHS-E, BASCIS and MASCIP to describe a pathway for life-long care |
| Rehabilitation Medicine Expansion Proposal. | Proposal for expansion of Rehabilitation Medicine in the UK | Position paper | 2016 – August | Reviews numbers of specialists in different countries and considers scope of the speciality (in 2015, not 2025). |
| Long-term neurological conditions | Long-term neurological conditions: management at the interface between neurology, rehabilitation and palliative care | Concise guidance to good practice | 2008 – March | Joint publication with Royal College of Physicians and National Council for Palliative Care |
BSPRM: Research, training and education.
The Covid pandemic had a significant and positive impact on education, training and research in Rehabilitation Medicine. We developed processes to increase national education and training using the internet, improving and using the Society’s website and using video-conferencing.
For many years, trainees had great difficulty in accessing regular training sessions. Regional groups were small and could not sustain an entire training programme, and national training sessions were too distant and could not be attended.
Ahmed Saif, Annie Price and many others developed a national training programme based on a combination of national video-linked sessions with speakers and local in-person education meetings based on the national talks. The BSPRM’s vital role was to support everyone developing the programme, and to host it.
All trainee doctors in the UK can access the training part of the website, which has other resources.
The Society has increased its academic support to members, primarily doctors at present, but the framework can easily be extended. We have subscribed to educational resources online that members can access freely. The national meetings were online for two years but have returned to in person meetings that are well attended.
Sara Ajina and Siva Nair founded a research collaborative, with a subsection aimed at trainees. To quote its home page, “Our Collaborative Research Network is not just for those individuals who may be ‘academic’, but for anyone who may be involved in research in any capacity.”
The British Society of Physical and Rehabilitation Medicine (BSPRM)
The British Society of Physical and Rehabilitation Medicine (BSPRM) has, as its objects (purpose):
“For the public benefit, the advancement of public health by:
- Promoting the understanding and delivery of rehabilitation within society for the benefit of anyone with any disability.
- Promoting the speciality of rehabilitation medicine; the medical component of multiprofessional rehabilitation teams.
- Educating health professionals about rehabilitation.
- Developing clinical and professional practice standards, including advice on measuring and improving adherence to the standards.
- Promoting and facilitating research in rehabilitation, and ensuring the useful results of such research are disseminated.
- To advance the education of the public in general, via health professionals, on the subject of rehabilitation and how that can be used to support people with disabilities.”
The constitution clearly states that: “Membership of the CIO is open to anyone who is interested in furthering purposes, and who, by applying for membership, has indicated his, her or its agreement to become a member and acceptance of the duty of members set out in sub-clause (3) of this clause.” Sub-clause three only says: “It is the duty of each member of the CIO to exercise his or her powers as a member of the CIO in the way he or she decides in good faith would be most likely to further the purposes of the CIO.”
Despite that, full membership is currently only open to doctors. The membership categories are online, and are:
Full: Any doctor working in Rehabilitation Medicine or any other speciality in a non-training post, full or part-time. £235.00pa
Associate: Senior AHPs and Nurses (Band 8 or above) with experience in rehabilitation and medical practitioners outside the UK or retired ordinary members. £80.00pa
Trainee: Working in a recognised speciality training post full or part-time. £90.00pa
Student: Medical Students (registered with UK Med School), Foundation Year and pre-speciality training doctors with GMC registration, £00.00pa
The Society has a range of committees, working groups, special interest groups, and other groups, such as the Council. Non-members may be invited to join or participate in working and special interest groups. For example, the Prolonged Disorders of Consciousness (PDOC) special interest group (SIG), run by Dr Judith Allanson, has two to three excellent meetings each year, attended by many professions, including lawyers.
Conclusion
The BSPRM is the only national organisation with rehabilitation as its primary interest, and it has demonstrated its commitment to multi-professional rehabilitation standards. On the other hand, its membership is mainly medical, and most of the members are Rehabilitation Medicine physicians with relatively few members from different medical specialities. Although other professions may join, they cannot be full members, which may be one factor behind the small number of non-medical members. The recent formation of the Clinical Post COVID Society as a working party within the BSPRM has attracted many people from many professions, and it now has far more members than the BSPRM; maybe this will precipitate change.