NICE's new guidelines on rehabilitation for chronic neurological disorders, promoting person-centred care and improved outcomes for patients across England.
The National Institute for Health and Care Excellence (NICE) recently published new guidance (the Guidelines) (NG252) on rehabilitation for children, young people and adults living with chronic neurological disorders which sets out comprehensive recommendations for how rehabilitation should be commissioned and delivered across England. The Guidelines cover a number of conditions commonly seen in catastrophic injury claims, including traumatic brain injury, spinal cord injury and functional neurological disorder (FND).
The Guidance advocates for a person-centred, coordinated and lifelong approach to rehabilitation to be adopted across hospital, community and social care settings, with the intention to create greater consistency in rehabilitative support and improve overall patient outcomes. The Guidelines also recommend holistic needs assessment including in respect of mental health, social participation and independence, as well as physical recovery.
A number of the recommendations, including the early identification and assessment of rehabilitation needs, individualised goal setting and coordinated rehabilitation plans, are unsurprising to those involved in handling claims for serious injury, given their emphasis on maximising overall function and enabling the injured person to live as independently as possible.
Other recommendations include:
- the designation of a single point of contact, such as a key worker or complex case manager, to coordinate rehabilitation and support individuals with complex needs in navigating rehabilitation services;
- integrated pathways for children, young people and adults, supported by clear coordination and follow-up; and
- workplace development and local capacity-building intended to address skills gaps in neurorehabilitation;
- simple re-referral processes to access further rehabilitation following discharge to encompass changing needs.
The NICE Guidelines NG252 represent a welcome opportunity to address variation in neurological rehabilitation, support early intervention and prevent long-term inequalities in health outcomes. From a practical perspective, however, it remains to be seen how the recommendations are to be implemented, resourced and funded in an increasingly challenging economic climate in which NHS services are already stretched.
Furthermore, whilst the NICE Guidelines NG252 recognise the critical role case management can play in effective neurorehabilitation and provide useful guidance, they are not mandatory. As such, their effectiveness and whether they will be widely implemented will only become apparent over time.
This article has been brought to you by Catherine Clegg of the Weightmans Brain Injury Technical Unit