Community hubs: taking the lead

CSP's Ruth ten Hove sets the scene for physio staff to lead and influence their development

Community hubs: taking the lead

The provision of effective community-based rehabilitation services is a huge priority for UK healthcare providers, and physiotherapy is key to their success. 

We’re living and working in a changing world, where people are living longer, but are not necessarily fitter and healthier. In our ageing population the prevalence of long-term conditions and – in particular – of people living with more than one long-term condition – is contributing to the demand for a change in the way healthcare services are delivered. More services will need to be delivered closer to people’s homes; there is an increasingly important role for prevention and self-management to empower people to take personal responsibility for their health; and there is a wider role for digital technology and innovation in shaping the future delivery of healthcare.

The NHS England long term plan makes a real commitment to improving rehab services. Over the next ten years, a far greater proportion of NHS resource will be directed to support people to recover and rehabilitate, and into services that meet people’s needs outside of hospital and in their own homes. In England £4.5 billion is promised for primary and community health services and there are similar policy commitments in the rest of the UK. 

Within this context, the CSP has started working with members of the profession and key stakeholder organisations to ensure that money is spent on better rehab.

We have and will continue to have an increasing demand on our rehab services. This is not just about the older population living longer, but also enabling people of working age with long-term conditions to live fulfilling lives. There is an opportunity for us to take stock of what is working well - lots is – and to influence how rehab services could be delivered for the future.  

We know what excellent rehab looks like: a full assessment that looks at all your health and care needs, supports you to establish personalised ambitious goals, which is backed up with an appropriate and funded plan that makes a difference to an individual’s quality of life. And empowering people to take responsibility for their own health and continue their rehab using local amenities (social prescribing).

We also know from our national work on hip fracture the importance of being able to provide continuity of rehab across the pathway, that is of the appropriate intensity and frequency to achieve individualised goals. 

Research has shown us the effectiveness of individualised rehabilitation within a group setting. ESCAPE, BEST, pulmonary and cardiac rehab all tailor exercises and goals within the group setting.  

Is it time to think differently about how we approach rehab? In particular, how we meet the needs of the population who are living with a number of conditions?

If you’re already doing this, we’d love to hear about it e-mail us at

Next 12 months

Over the next year the CSP will be focused on some key tasks, and creating opportunities for visionary and transformational thinking with researchers, clinicians and service managers across specialties and sectors.

These will include:

  • building effective and sustainable hip fracture networks charged with driving up quality across the whole hip fracture pathway
  • working with others to improve access to pulmonary rehab services
  • gaining consensus across the profession in the development of community rehab standards
  • working with NHS England primary care networks to ensure inclusion of community rehab 

Opportunities for members:

  • growing group-based approaches to rehabilitation
  • shaping the development of multiple conditions rehab
  • expanding the potential of support workers workforce in community rehab


  • this is the direction our profession is going
  • physiotherapy can take the lead
  • physiotherapy workers are key to the future of UK healthcare
  • what you do is extremely valuable – shout about it
  • there are complex challenges but they can be met

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