There are strong economic, ethical and ‘quality of life’ reasons to improve access to rehab services, and it's time to make the UK health and care systems more rehabilitative as a whole.
To bring about the necessary changes and investment in community rehabilitation, we need to work with all those with a shared agenda in making this happen.
This is why the CSP initiated a Community Rehabilitation Alliance of national charities and professional bodies who are all committed to improving commissioning, planning and delivery of rehabilitation. The priorities are:
- To gain political commitment to delivering universal access to rehabilitation to meet needs
- To improve the quality of rehabilitation through better commissioning and planning and delivery
- To create public awareness of an individual’s entitlement to rehabilitation
The rehabilitation issue
There is a strong and growing demand for quality rehabilitation. This is caused by improved mortality rates for many acute conditions and more people living longer with one or more long-term conditions. The demand for rehabilitation services is not currently being fully met.
While there are excellent examples of rehabilitation services, they are not consistently available. Services are often not joined up between acute, residential and home settings, so people can easily be lost to the system.
Where people can access services, they often have to wait too long, making rehabilitation more difficult or less effective.
There is also poor awareness of the benefits of rehabilitation among the public, health care professionals and commissioners.
The rehabilitation imperative
Rehabilitation enables people to regain life skills, maintain mobility and manage symptoms. It can slow disease progression and optimise the effectiveness of treatments. It is also critical to prevention. It can reduce fragility fractures, falls risk and the development of long term conditions. All of which helps to reduce readmissions to acute services, reduces social care needs and helps prevent disability, with its impact on people’s mental and physical health.
The imperatives for improved rehab services can be classified as:
- Quality of life - as a society we have made significant medical advances in life-preserving treatments. We now need to give as much focus on quality of life.
- Economic - quality rehabilitation reduces demand on the most costly and intensive parts of health and social care systems and supports people and their carers to participate economically in society. Quality rehabilitation requires investment and solutions that are creative, responsive and evidence-based to make the health and social care system more sustainable.
- Ethical - people have a right to rehabilitation so that they can participate in their local communities. The failure of current health and social care systems in the UK to meet rehabilitation needs drives the cycle of disability, poverty and health inequality. This cycle needs to be broken.
Time to act
The World Health Organisation has identified rehabilitation as a priority for integrated healthcare systems. It must be recognised as a central tenet of health care alongside prevention, health promotion, medical treatment and palliative care.
The current focus of all UK governments is to integrate care across different parts of the system, and to shift focus into primary and community services. It is time to take this opportunity and make UK health and care systems more rehabilitative as a whole.
Covid-19 has shone a spotlight on rehabilitation. This has the potential to be a catalyst for lasting change.
In the run-up to the Westminster elections in December 2020 the alliance asked candidates to support a right to rehabilitation being included in the NHS constitution and the NHS mandate in England.
After the elections in February 2020, we launched a report with alliance partners about the importance of Community Rehabilitation to people’s lives, and held a successful parliamentary event in Westminster with Sue Ryder and the Royal College of Occupational Therapists.
More recently on 8 May 2020 22 members of the Community Rehabilitation Alliance jointly submitted evidence to the Health and Social Care Select Committee inquiry Delivering core NHS and care services during the pandemic and beyond.
Alliances have been set up in Scotland and Wales, and is in the process of being set up in Northern Ireland. Campaigning on this issue will be a priority in the run-up to the national elections in Scotland, Wales and Northern Ireland scheduled to take place in May 2021.