In 1978, I submitted my first paper to the British Medical Journal. It concerned what we now refer to as functional disorders, the phenomenon of illness with no identified disease causing it. I have been interested since. A recent editorial by an Oxford colleague, Anton Pick, discussing whether patients with Long Covid had a
This section of the site houses rehabilitation blog posts, the posts from Rehabilitation Matters. The posts have been grouped into various categories, which may change from time to time. A post may be included in more than one category. Each post has some tags (at the bottom) to find other posts on the same topic. The posts are shown in the pages in their categories, with the most recent six shown separately at the end of this page – here. There is also an archive of all posts published on one page. You may register to be notified about new posts as they are published – see the sidebar on the right. Posts can be searched (not separately) using the search on the right. This introductory page introduces the overall goals of the posts and then discusses each category. You can move directly to a category using the menu or from the descriptions below.
Table of Contents
Purpose, objectives, values
The primary purpose of this rehabilitation blog is to develop and instil among clinicians involved in or interested in rehabilitation an identification with rehabilitation that is equal to any loyalty to a particular profession. I hope that others who may visit this site – patients and families, people paying for rehabilitation, politicians and people who are just curious – will also appreciate that rehabilitation is more significant than any single profession’s activities and that rehabilitation is a collaborative, team-based endeavour.
The direct objectives of the posts are to:
- develop stronger links between the many different professions and services currently delivering rehabilitation in practice;
- to increase links within professions, such as medicine, where many different groups of clinicians deliver rehabilitation but do not have any formal connection with the rehabilitation community;
- to increase awareness of rehabilitation as a specialisation within healthcare, over and above specific professional expertise, so that professions other than medicine can eventually gain formal recognition of the rehabilitation expertise;
- to disseminate information and evidence that could improve the standard of rehabilitation services;
There are other, less focused and indirect objectives. They are to:
- broaden the interest of all professions outside their profession and health, to increase awareness of, interest in, and concern about social, political (with no party allegiance), economic and artistic matters, all of which are of great importance to our patients, more important to them than our rehabilitation;
- stimulate readers to question any received wisdom they may rely on, to reconsider what they do and why;
- to encourage all professions to participate in discussions and debates about any aspects of rehabilitation.
Posts will adhere to the following values:
- respect for others, however much you disagree with the opinions given or the interpretation of evidence;
- unbiassed presentation and use of evidence whenever it is available, including disclosure of known evidence contrary to the point of view;
- equity and justice, having due regard to and acknowledging the interests of others who might be affected by a proposal;
- honesty, disclosing any material facts that others could consider to influence statements made or conclusions drawn;
- Not discriminate against any group, including but not restricted to those listed in legal Acts of parliament.
There are many posts. They are grouped into different categories, and they are also tagged. To make life easier, each category has been given a separate section below.
From the journals
This blog complements my Clinical Rehabilitation journal Twitter feed @ClinicalRehab, where, since March 2018, I have posted tweets drawing attention to articles that are, or should be, of interest to anyone working in rehabilitation. I tweet something new most days; blogs will be less frequent! Generally, the blog post will contain something stimulated by the article, which will only sometimes be a new publication. You may look at a list of tweets from @ClinRehab here. To look at the posts, click here.
This blog includes anything relating to rehabilitation that is not covered by specific blogs. They may contain comments on general policies from any source (e.g. Department of Health and Social Services, National Institute of Health and Clinical Excellence) relating to rehabilitation. They may cover matters relating to organisations and professional bodies interested in rehabilitation. They may be something I want to write about. It is an eclectic mixture of posts. To view them, click here.
Models of illness
These posts relate to the interface between models of illness, specifically the biomedical and biopsychosocial models, and how they may influence the rehabilitation process and the design of rehabilitation services. They continue the theme running through this site, that good quality rehabilitation can only occur if the clinical practice, the organisation of services, and the commissioning of services are based on the correct model. The post will often discuss how failure to use a suitable model is harmful. To see the posts, click here.
Education and training
As you would expect, the posts in this category relate to education and training. Although much of the material arises from my interest in developing training for doctors (I led the work on a new curriculum and syllabus), I have become increasingly interested in improving the training available to other professions. The posts, I hope, expand upon that. The section of this site on capabilities (here) also expands on it. The posts can be accessed here.
This category of posts concerns the organisation of services – or, to be more brutal and honest, the lack of coherent organisation. It also includes posts suggesting how services can be improved, including by you. It is a part of raising your political interest. Decisions about resourcing rehabilitation and the organisation of services are intensely political, and we need to recognise that and act accordingly. Posts can be read here.
The posts in this category relate to the process of research, research methodology, and other similar matters. They are not explicitly concerned with the output or results. They can be seen here.
When this site started in 2020, the UK specialist medical society was the British Society of Rehabilitation Medicine. (BSRM). There was an active debate about changing the name, and I posted several posts relating to the discussion. They remain here for historical interest. My opinion was not accepted in the vote at the end of 2021. The name changed in March 2022 to the British Society of Physical and Rehabilitation Medicine, which has its own category.
The posts in this category concern anything related to the British Society of Rehabilitation Medicine, one of two specific rehabilitation societies in the UK. The other is the older of the two, founded about eight years earlier – the Society for Research in Rehabilitation.
The posts cover general matters and my observations on the debate, and they can all be accessed here.
In April 2022, the British Society of Rehabilitation Medicine officially changed its name to the British Society of Physical and Rehabilitation (BSPRM). Any posts concerning the UK specialist medical rehabilitation Society will now be filed into this category. They focus on matters that concern the BSPRM though I hope many will have a broader interest. They can be seen here.
What professions add
The primary purpose of this category is to persuade people from different professions to put their head above the parapet and specify what unique expertise they bring to the multi-professional team. The only one so far is on a doctor’s contribution. The posts also include some considering profession-specific research, investigating what a profession add. To see them, click here.
All blogs and archive
Many blog posts go out of date and are no longer categorised though they remain available. If you wish to look through all blogs ever published, whether categorised or not, they are arranged in reverse date order, available here.
Nine most recent blog posts
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
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
At 02.00 hrs on November 29th, I had an epiphany, “a moment of sudden and great revelation or realisation”. [OED] For many years, I have emphasised a distinction between assessment as a process and assessment as a measure (e.g. “the outcome assessment was the Rivermead Mobility Index”), and I have suggested that both should
In May 2021, Dr Sabena Yasmin Jameel published her University of Birmingham PhD thesis on Enacting Phronesis in General Practitioners. John Launer wrote about it on November 2nd, and I saw a tweet about his article. She has studied wisdom in general practitioners, but the findings apply to all healthcare professionals. Indeed, rehabilitation professionals
The new, significantly changed, and improved 2021 Rehabilitation Curriculum for training doctors in rehabilitation became active on August 1st 2021. This page introduces the new curriculum and its associated documents. In the UK, Rehabilitation Medicine (but not the practice of rehabilitation generally) has previously had a limited scope, reflecting its history. The 2021 curriculum
“Rehabilitation is a way of thinking, not a way of doing.” I have written two editorials extolling this approach, but I have recently realised that I have not explained the specific “way of thinking”. This omission struck me as I was writing some new pages for the site (not yet published) on training in
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,
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