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Neurorehabilitation Services Continue To Be Inadequate : Evidence Mounts But Still No Action

MPs at today’s Westminster debate on Acquired Brain Injury (ABI), heard Chris Bryant MP, Chair of the All-Party Parliamentary Group (APPG) on ABI highlight the poor state of UK neurorehabilitation services, with only 40% of individuals in Major Trauma Centres receiving specialist in-patient neurorehabilitation, a shortfall of 330 beds, and a lack of health professionals including consultants in rehabilitation medicine.

In September 2018 the APPG on ABI published a report ‘Acquired Brain Injury and Neurorehabilitation – Time for Change’ which called for immediate action to address the issues surrounding neurorehabilitation for children, young people and adults with ABI in the UK.

Neurorehabilitation is one of the most cost-effective interventions available to the National Health Service (NHS). The report ‘Specialist Rehabilitation following Major Injury (NCASRI)’ published in April this year found that in a group of 1381 individuals assessed as requiring specialist rehabilitation, only 40% received it. Those who did receive specialist rehabilitation did well, with 94% becoming more independent in their activities of daily living, which in turn reduced the costs of on-going care by an average of £536 per week.  Extrapolated over their lifetime, the average net life-time savings from neurorehabilitation amounted to just over £500,000 per patient, meaning that the total savings generated from this study group was £582 million.

The cost of meeting the shortfall of 330 rehabilitation beds was estimated at just
£53 million per year, which would still generate net savings in excess of £500 million per year in longer-term care costs.  It is no longer a question of whether the government can afford to meet this shortfall in trauma rehabilitation beds – but whether it can afford not to.

Commenting on behalf of the British Society of Rehabilitation Medicine (BSRM), and as Director of the UK Rehabilitation Outcomes Collaborative (UKROC), Professor Lynne Turner-Stokes said: “There is now substantial and robust evidence to support the clinical and cost-effectiveness of neurorehabilitation.  Although individuals with complex needs following ABI may need a longer stay in hospital, the front-loaded cost of providing early specialist rehabilitation is rapidly offset by the longer-term savings in the cost of community care, making specialist rehabilitation for these individuals one of the most cost-efficient interventions in healthcare.  Moreover the benefits for patients and their families are immeasurable.  The NHS can no longer ignore the mounting evidence, and the BSRM is demanding improved in-patient and community service provision.”

Dr Andrew Bateman, Chair of the United Kingdom Acquired Brain Injury Forum (UKABIF) said: “The excellent advances in emergency and acute medicine mean that individuals now survive with an ABI, but many require early and continued access to rehabilitation to optimise their recovery and maximise their long-term potential.  The services and expertise are just not available which is extremely short-sighted on the part of the NHS, and hugely detrimental long-term for individuals with ABI.”

Notes:
Specialist Rehabilitation following Major Injury (NCASRI) Final Audit Report April 2019

https://www.kcl.ac.uk/cicelysaunders/about/rehabilitation/National-Clinical-Audit-

www.kcl.ac.uk
The National Clinical Audit of Specialist Rehabilitation for Patients with Complex Need following Major Injury is a major national clinical audit.. It has been commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and is funded by NHS England and the Welsh Government.

 

The NCASRI audit was commissioned by the Healthcare Quality Improvement Partnership (HQIP), on behalf of NHS England, ran from 2015-18 and was led by Professor Lynne Turner-Stokes at Northwick Park Hospital, London.  The audit was implemented because it was acknowledged that:

  • Rehabilitation had been overlooked in the initial planning and development of the major trauma networks
  • There was a lack of information on the extent of current service provision and how specialist rehabilitation units integrated with the acute trauma services
  • Existing service capacity was insufficient to meet demand, but very little information was available about the rehabilitation needs of severely injured patients or how well these needs were being met

Acquired Brain Injury and Neurorehabilitation – Time for Change

https://www.ukabif.org.uk/campaigns/appg-report/

The report, published in October 2018 by the APPG on ABI, was the result of a series of meetings with experts about the issues surrounding the provision of neurorehabilitation services for children, young people and adults with ABI in the UK, focussing on education, criminal justice, sport-related concussion and the welfare benefits system.

The key neurorehabilitation recommendations were:

www.ukabif.org.uk
UKABIF is a registered charity number 1128284 and a company limited by guarantee registered in England and Wales Company Number: 6520608. Address of the Company’s Registered Office: 40 Holborn Viaduct, London, EC1N 2PZ.
  1. Rehabilitation Prescriptions should be available to all individuals with an ABI on discharge from acute care, held by the individual with copies made available to the general practitioner
  2. A national review of neurorehabilitation is required to ensure service provision is adequate and consistent throughout the UK
  3. The Government should collate reliable statistics for the number of individuals presenting at Accident and Emergency Departments with ABI, and record the numbers that require and receive neurorehabilitation.
  4. There should be a significant increase in neurorehabilitation beds and neurorehabilitation professionals so that every trauma centre has a consultant in rehabilitation medicine, and individuals with an ABI have access to neurorehabilitation
  5. Cooperation between key government departments (i.e. the Department of Health and Social Care and the Department for Work and Pensions) is required to review funding for in-patient and community neurorehabilitation services

APPG on ABI

Formed in 2017 to raise awareness of ABI, the APPG on ABI is a voice for those who are not always heard in Westminster and beyond, raising key issues across health, social care and welfare and seeking improvements in support and services for people directly affected by ABI, and for their families and carers.

 

Westminster Hall Debate 2nd July 2019

Chris Bryant, MP has secured a debate on acquired brain injury in Westminster Hall on Tuesday 2nd July from 9.30am to 11am. MPs from all parties will take part in the debate and will ask the government’s Parliamentary Under Secretary of State for Health, Seema Kennedy to respond. You can watch the debate on parliament TV by clicking here

https://www.parliamentlive.tv/Event/Index/c593b984-6e6f-40e5-b8b2-dc8794b2aef2

Thank you again to Chris Bryant, MP for providing a platform for people to raise issues concerning acquired brain injury.

#AcquiredBrainInjury #rehabilitation #neurorehabilitation #ChrisBryant #JohnHayes #ParliamentDebate #Heath #SocialCare #Rehabilitation #Education #Offending #MP #Politics #ABIAPPG #BrainInjury #AllPartyParliamentaryGroup #APPG #UKABIF #Timeforchange

Dr Andrew Bateman – New Director Of NIHR Research Design Service East Of England

Dr Andrew Bateman, Chair of the United Kingdom Acquired Brain Injury Forum (UKABIF) since 2017, is now the new Director of the National Institute for Health Research (NIHR) Research Design Service (RDS) East of England (EoE).  Based at the University of Essex, Andrew will combine the role with his appointment as a Reader in the School of Health and Social Care at the University.

Commenting on his appointments Andrew said: “I’m looking forward to closely liaising with RDS colleagues throughout the East of England and also with Directors of the other RDSs in England to provide a seamless and equitable service to health researchers in the region applying for peer-reviewed funding.  The School of Health and Social Care provides training to occupational therapists, speech therapists, nurses, psychologists and more so I’m also looking forward to supporting multidisciplinary health research at the University of Essex.”

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#TimeforChange Success for Physios

Physiotherapists Hannah Farrell and Susan Pattison successfully raised a motion to actively endorse the APPG for Acquired Brain Injury’s report: Acquired Brain Injury and Neurorehabilitation: Time for Change and support its recommendations at the Chartered Society of Physiotherapist’s Annual Representative Conference on 4th June 2019.

They specifically requested a high profile campaign to highlight the importance of physiotherapy throughout the brain injury pathway emphasising neurorehabilitation, sports related concussion, brain injury as a long term condition and those working in education, social services, remand centres and prisons.

They also requested an online training package to ensure that physios in all sectors have the necessary skills to complete the Rehabilitation Prescription and keep physios as primary drivers and educators at every stage of rehabilitation for acquired brain injury.

The motion was passed with 87% voting for and 13% against.

We are so proud of Hannah and Susan’s hard work and drive to get this motion passed.

Brain Injury Reception at The Speakers House a huge success

UKABIF and Chris Bryant, MP hosted a successful reception at The Speakers House in Parliament on 22nd May 2019. The event was attended by over a hundred people including many with a lived experience of brain injury as well as charities, support groups and those working as clinicians and academics.

Around thirty MPs made the time to meet their constituents despite a very busy day in parliament. They included Minister for the Treasury John Glen, previous Health Minister Steve Brine and stalwarts of the APPG for Acquired Brain Injury; Liz Twist, John Hayes, Carolyn Harris and Sharon Hodgson.

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Backbench debate on Acquired Brain Injury takes place in Parliament

A second backbench debate on acquired brain injury took place in parliament on Thursday 9th May 2019. The motion was raised by Chris Bryant, MP and Sir John Hayes, MP. 16 MPs took part speaking on behalf of their constituents or discussing their own personal connection with acquired brain injury. The government response was presented by the Under Secretary of State for Health and Social Care, Seema Kennedy.

Chris Bryant, Chair of the All Party Parliamentary Group for Acquired Brain Injury has championed raising awareness of ABI in parliament. He spoke first and was able to pinpoint many of the problems facing people with brain injury from issues with benefits to the need for neurorehabilitation.

Sir John Hayes is himself a brain injury survivor having sustained serious injuries in a road traffic accident in his twenties. John very eloquently spoke of the subtle changes which can take place which result in a world of difficulties for the survivor and their families.

Liz Twist is also a member of the APPG for ABI and a strong advocate for better support for children with acquired brain injuries. Liz outlined the need for better awareness in schools and special services for children with brain injuries.

Chloe Hayward of UKABIF who jointly provides the secretariat for the All-Party Parliamentary Group and has been working with Chris Bryant and others to push for better access to neurorehabilitation and recognition of acquired brain injury said,

‘It was really heartening to see that many of our key issues were raised in parliament today. Neurorehabilitation must be accessible to everyone with an acquired brain injury and follow on support post discharge is essential to prevent people and their families from slipping into crisis.’

Chloe thanked other charities for their support in briefing MPs about the event.

You can read a full transcript of the debate here: https://hansard.parliament.uk/Commons/2019-05-09/debates/FBF9F722-1D93-4721-B8C9-EF46E782F073/AcquiredBrainInjury

Second backbench debate on acquired brain injury!

UKABIF are delighted that a second backbench debate on acquired brain injury will take place in parliament on Thursday 9th May. The debate will start at around 11.30 am and will give MPs the chance to speak on behalf of their constituents who have suffered from an acquired brain injury or work in this area.

MPs Chris Bryant and John Hayes will lead the speeches and will refer to the APPG for Acquired Brain Injury’s Report and Recommendations. They will state support for the conclusions of the report and urge the government to coordinate responses across the departments so that those who have sustained brain injuries are guaranteed full neuro-rehabilitation as needed.

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Nominate UKABIF for Ecclesiastical Award

UKABIF is a charity which is registered in England and Wales under charity number 1128284. We raise awareness of acquired brain injury – it’s effects are devastating, but is little understood. We are urging our members and wider contacts to nominate us for the Ecclesiastical Movement for Good Awards Programme. If we receive enough nominations we would receive an award of £1000.

Please take a moment to nominate UKABIF and share with your colleagues – thank you!
bit.ly/2ViZWAa

Brain Injury Organisations Unite in Response to the Mental Capacity Act Code of Practice

Charities, organisations, professionals and individuals concerned with how the Mental Capacity Act (MCA) is being applied to individuals affected by acquired brain injury (ABI) have united to submit an agreed letter to the Ministry of Justice who are currently reviewing the Act’s Code of Practice. Since the House of Lords review of the MCA was published, increasing concerns have been raised about the how the Act is applied to people with an ABI, in particular the risks associated with a lack of knowledge of the condition by professionals undertaking Capacity and Best Interests assessments has been identified. The signatories of the joint-submission represent a very broad range of UK charity and professional groups, uniting to draw attention to the problems experienced by families affected by ABI and this is a unique collaboration. The submitted letter is attached below , please feel free to distribute this and to use the content if you are experiencing difficulties with the application of the MCA.

Acquired Brain Injury Collaboration Letter Submission

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UKABIF welcomes enquiries from the media. We are able to provide information about all aspects of acquired brain injury as well as experts in the field to talk about topical issues. Please call 0845 6080788 or 07903887655.