ABI ALLIANCE REHABILITATION PRESCRIPTION CAMPAIGN:

MEDIA BACKGROUND INFORMATION

ABI ALLIANCE REHABILITATION PRESCRIPTION CAMPAIGN

 

Objectives

The Campaign objectives are simply:

 

  • To highlight the role of the RP

  • To ensure that post-discharge the individual, their family/carers have:

  • A copy of the RP

  • An appointment with the GP to discuss its contents

  • A plan for accessing the rehabilitation services as detailed in the RP

  • A copy of the RP

 

Key communication messages
Message 1: A Rehabilitation Prescription (RP) is a valuable tool that documents the rehabilitation needs of the person following an Acquired Brain Injury (ABI).  On discharge from a hospital, a person with an ABI and their GP should receive a copy of their RP so that access to rehabilitation services can be planned and implemented.
 

Message 2: The ABI Alliance was established in 2016, and is a collaborative venture between charities, professional groups and industry coalitions working in the field of ABI.  The purpose of the Alliance is to use collective influence and work together to improve the lives of those affected by ABI.


REHABILITATION PRESCRIPTION

 

In 2010 the National Health Service (NHS) Clinical Advisory Group for Major Trauma (Trauma CAG) reported to the Department of Health and recommended the establishment of services in Major Trauma Networks to provide co-ordinated pathways of care.  It also recommended that every patient with major trauma should receive high quality rehabilitation and those admitted to a Major Trauma Centre (MTC) should have their rehabilitation needs assessed and documented through a Rehabilitation Prescription (RP).   However no formal provision for rehabilitation was made. 

 

There are two forms of RP, standard and specialist:
Standard RP: A generic tool for use in Level 3 rehabilitation services.  Following a major trauma, the large majority of individuals will progress satisfactorily to recovery along the patient pathway with the support of their local services (Level 3).

 

Specialist RP (SpRP): Some individuals will have more complex needs requiring treatment in Level 1 and 2 rehabilitation services and require a SpRP.  The SpRP is a requirement for referral to the Level1/2 specialist rehabilitation services commissioned by NHS England.

 

The National Clinical Audit October 2016 entitled ‘Specialist Rehabilitation for Patients with Complex Needs Following Major Injury (NCASRI)’ highlighted that the use of RPs was inadequate and patients rarely received a copy.  In March 2017, the United Kingdom Acquired Brain Injury Forum (UKABIF) sent a Freedom of Information request to all Clinical Commissioning Groups asking if they logged RPs.  The feedback was poor, only four CCGs were positive.  Most CCGs referred UKABIF to the NHS Trust for the information.  Recognition of the RP was inexcusably low and the General Practitioners (GP) rarely use them.   

 

KEY ISSUES

 

  • The RP is a valuable tool that documents the rehabilitation needs of the individual.  However, the RP has no value if the individual with an ABI and their GP do not receive a copy.  If the individual and GP do not know what rehabilitation is required then no access to services can be planned or implemented
     

  • The ABI Alliance believes that the RP should be given to every individual, both children and adults with an ABI, on discharge from hospital, with a copy sent to their GP.  This will then provide a useful resource for the GP to work with the individual and facilitate access to rehabilitation services in the community leading to maximised health outcomes  
     


ABI ALLIANCE

 

Established in 2016 the Acquired Brain Injury (ABI) Alliance is a collaborative venture between charities, professional groups and industry coalitions working in the field of acquired brain injury.  The purpose of the Alliance is to use collective influence and work together to improve the lives of those affected by acquired brain injury.

 

Mission
To improve the management and service provision for children and adults with ABI in the UK.

 

Vision
ABI is recognised as a chronic, life-long condition.  All children and adults with ABI the UK should receive coordinated and patient-focussed care that includes rehabilitation. 

 

Objectives

  • To raise awareness of ABI and seek improvements in support and services for people directly affected by ABI and also their families and carers across the four nations of the United Kingdom

  • To provide a collective voice for people with acquired brain injuries, their carers and those working in the field

  • To raise key issues across health, social care and welfare which all affect people living with ABI in the UK 

  • To come together to respond to changes in health and social care provision which affects people with acquired brain injury.

  • To feed into the All Party Parliamentary Group for Acquired Brain Injury

 

Membership

The current membership of the group is listed below but the group is open to all non-profit organisations working in the brain injury field:

 

  • Association of Personal Injury Lawyers (APIL)

  • Action for Rehabilitation from Neurological Injury (ARNI)

  • Brain Injury Rehabilitation Trust (BIRT)

  • Brain Injury Social Work Group (BISWG)

  • Brain and Spine Foundation

  • British Society of Rehabilitation Medicine (BSRM)

  • British Society of Brain Injury Case Management (BABICM)

  • Child Brain Injury Trust

  • Independent Neurorehabilitation Providers Alliance (INPA)

  • Meningitis Now

  • One Punch

  • The Children’s Trust

  • Queen Elizabeth’s Foundation for disabled people (QEF)

  • UK Acquired Brain Injury Forum (UKABIF)


ACQUIRED BRAIN INJURY
Definition

Acquired Brain Injury (ABI) is any injury to the brain which has occurred following birth.  It includes Traumatic Brain Injuries (TBIs) such as those caused by trauma (e.g. from a road traffic accident, fall or assault) and non-traumatic Brain Injuries (non-TBIs) related to illness or medical conditions (e.g. encephalitis, meningitis, stroke, substance abuse, brain tumor and hypoxia). 

 

ABI is leading cause of death and disability in the UK.  It is a chronic condition with life-long consequences.  

 

Key facts  

  • 1.0-1.4 million people attend hospital every year with an ABI

  • 348,934 admissions to hospital with an ABI (2013-2014)

  • ABI admissions have increased by 10% since 2005-2006

  • Men are 1.6 times more likely than women to be admitted for a head injury

  • Incidence of female head injury has increased by 24% since 2005-2006

  • In 2013-2014 there were 162,544 admissions for head injury - 445 individuals every day or 1 every 3 minutes

  • More than 1 million people live with the effects of brain injury

  • Estimated cost of TBI is £15 billion (based on premature death, health and social care, lost work contributions and continuing disability), equivalent to approximately 10% of total annual NHS budget

 

 

Consequences

Frontal lobe: planning, reasoning, speed of processing, personality, speech, behaviour

Parietal lobe: understanding speech

Occipital lobe: vision

Temporal lobe: memory

Cerebellum: balance

Brain stem: respiratory, temperature regulation, fatigue

  • Physical

  • Cognitive

  • Emotional

  • Behavioural

  • Social and employment

  • Family


The brain injury, whatever form it takes, can cause physical, cognitive, academic and psychosocial effects, which may be temporary or permanent with life-long disabilities.

 

Neurorehabilitation
After a brain injury early access to specialist neurorehabilitation (NR) is a critical component of the care pathway.  NR has a key role in the management of patients admitted to hospital with ABI who have complex rehabilitation needs and should be implemented after their immediate medical and/or surgical needs have been met.  NR can play a major role in relieving the pressure on beds in the acute services.   It also supports the safe transition of the individual back into the community, where access to ongoing NR is also a key requisite to maximising health outcomes. 

 

Treatment of ABI and categories of individuals requiring NR    

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Individuals with an ABI requiring rehabilitation are categorised as A, B C or D, defined according to the complexity of their needs.  They are referred to the relevant specialist, approved NR service ranging from Level 1 to Level 3 Units,  where Level 1 Units represent high cost/low volume services for Category A individuals,  Level 2 Units mainly provide services for Category B individuals and  and Level 3 Units mainly serve Category C and D individuals.

Care Pathway
The Care Pathway illustrates the journey for the individual with an ABI. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Because of the expert emergency care services, Major Trauma Networks (MTN), hyper-acute stroke units and defibrillators in public places, individuals with an ABI are more likely to survive than they would have done several years ago, albeit with catastrophic brain injury and its consequences.  Care of these individuals in the acute setting is excellent, but many do not subsequently experience all aspects of the pathway, particularly with regard to NR.

 

For further information please contact:

 

Chloe Hayward   Email: info@UKABIF.org.uk  Mobile:: 07903887655

Louise Blakeborough  Email: lblakeborough@chapterfive.co.uk  Mobile: 07831444789 

 

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ABI Alliance 2018  |   email: info@abialliance.org

Brain Injury Touchpoint
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