Community Rehab Alliance
The Community Rehab Alliance (CRA) was founded in December 2019 to campaign for better community rehabilitation services, especially during the UK general election. It was based within the Chartered Society of Physiotherapy, and I first wrote about it on June 5th, 2021. From a standing start, it has become quite influential and recently published the Rehab on Track. Community Rehabilitation Best Practice Standards. The CRA is fascinating because, as far as I can see, it has no official status, constitution, dedicated funding or website. It is a tribute to trust and collaboration between over 50 organisations aiming to improve rehabilitation. My first page is now inaccurate and incomplete; this is a new page outlining the position on 31st May 2023, when there are four alliances, one for each UK country.
Table of Contents
The Community Rehab Alliance
At the October 2019 joint meeting of the Society for Research in Rehabilitation and the British Society of Rehabilitation Medicine (BSRM), posters and flyers were advertising the Community Rehabilitation Alliance as a pressure group to improve community services. It was launched as the Community Rehab Alliance only a short time afterwards.
It has been hosted by the Chartered Society of Physiotherapy, who provide administrative support and webpages. They “collaborate, don’t compete”. The Alliance in England has over 50 organisations covering professional organisations, patients and care organisations, and bodies covering research and specific diseases or disabilities.
Community Rehabilitation Standards.
The Alliance of more than 50 organisations has achieved significant work over the last two years, gaining universal agreement and support for a document setting standards for localities to achieve. They are aimed at the new Integrated Care Systems (ICS) and their associated Boards (ICBs).
The standards cover seven fundamental principles:
- Referral processes should be explicit, easy, efficient, and equitable
- Rehabilitation interventions should be timely, co-ordinated and prevent avoidable disability
- Rehabilitation interventions should meet patient needs and be delivered in an appropriate format
- Rehabilitation pathways should meet needs and be provided locally with access to specialist services
- Rehabilitation programmes should enable patient optimisation, self-management and review
- Rehabilitation services should be well-led, adequately resourced and networked to other services
- Rehabilitation services should involve families.
While I would probably have a slightly different set of principles, I think these are reasonable. I am delighted to see they do not refer to disease-specific services or specialist services. The focus is on community services, but they refer to networks and acknowledge the importance of hospital services.
Right to Rehabilitation
The CRA has also developed a Right to Rehab position statement, which covers many of my concerns, such as service fragmentation, lack of staff, and need for training. They make the case under four headings: an ethical imperative, the second quality of life, the third economic and the last functional benefits.
They set out 5 issues:
- Services are patchy and vary greatly between localities with areas of deprivation, which have the highest need, being least well served,
- The fragmentation of services, a problem I have repeatedly mentioned (e.g. here),
- Long waits,
- A lack of any useful data, because healthcare systems are only interested in diseases, not disabilities,
- A marked lack of people, equipment, and other resources. The lack of data hides this to an extent.
They also highlight the huge demand arising from Long Covid.
CRA - discussion
Initially, in June 2021, I was concerned by the absence of any usual features of an organisation, such as rules and processes, a structure, a website, etc. but two years on, it is functioning well, and I am unaware of any problems. I guess the Chartered Society of Physiotherapy supports it because it furthers their charitable objectives.
Its success may be helped by the CRA being entirely composed of organisations with no individual members. People attending have less to lose and more to gain from collaboration and being trusting and supportive.
