Appoint rehab leads across UK or risk health crisis, alliance warns

In its updated manifesto, the Community Rehab Alliance (CRA) called for every Integrated Care Board to have a rehab lead with responsibility for ensuring effective provision and integration of services for physical and psychological rehabilitation.

The CRA, of which CSP is a member, has long called for a national review of current rehabilitation provision and support, and campaigners welcomed the appointment of a director of hospital discharge and rehabilitation for NHS England from December.

However, the refreshed manifesto of the alliance of more than 50 charities, trade unions and professional bodies calls for planning to be done on a local level, too, to stop access to rehab being a postcode lottery.

This would allow innovations in rehab services developed during the pandemic, including new models of care, different ways of working and greater use of technology, to be rolled out across the UK.

The backlog of community rehab treatments caused by the pandemic could see many with long-term conditions, frailty and falls, vision rehabilitation and injuries experience a spiralling decline in their mental and physical health.

And the UK could be heading for an epidemic of health problems as last week’s Active Lives Adult Survey showed record levels of inactivity in the UK population brought about by the pandemic, with those from ethnic minorities and in deprived areas hardest hit.

Modelling shows that if rehab gaps aren’t addressed, many patients who remained independent through rehab could deteriorate to the point they can no longer live in their own homes, putting further pressure on the care system.

Addressing the rehab backlog would require a coordinated effort and investment across the UK, with rehab leads needed to close gaps in provision and put in place a rehab workforce that is skilled and strong enough to provide high-quality, person centred care.          

The CRA manifesto was updated to reflect increasing pressures from the pandemic, when community rehab services were paused so physio workers could be redeployed to the acute sector.

Post-lockdown, a snapshot survey of CSP members from nearly 300 services across the UK found that one in five services had not restarted. This is despite research showing more than 900,000 Long Covid patients currently need rehab in order to regain their health.                     

The government was urged to take the opportunity to use community rehab more effectively to enhance patient outcomes, and relieve the pressure on social care, GPs and hospitals.

The alliance called for the government to amend the Health and Care Bill currently passing through parliament to mandate every Integrated Care Board to have a Rehabilitation Lead and deliver a rehabilitation workforce with the right numbers and skills to meet population need.

It also pushed for local authority rehabilitation services and staff to be included in the list of regulated adult social care activities so that robust monitoring and reporting would ensure the same amount, quality and range of services were offered across the country. This would also make community rehab an equal priority with domiciliary care, and nursing and residential care in local authority adult social care planning and provision.

CRA co-chair Sara Hazzard said: ‘With the NHS stretched to the limit, the government must ensure it strengthens community rehab when it “builds back better” to relieve pressure on the whole healthcare system.

The current patchy provision of community rehab is fuelling health inequity, with levels of ongoing ill health and disability higher in areas of deprivation.

Equal access to rehab for all will give patients the right treatment they need to recover as much as they can, and live well for as long as they can.