The challenges facing Brain Injury services

This interview, with CEO Richard McKenzie, was published in February’s Healthcare Business magazine:

Brain injury is the leading cause of death and disability worldwide; approximately one million people live with an Acquired Brain Injury in the UK.  Specialist neurorehabilitation services play a vital role in the management of patients admitted to hospital by taking them after their immediate medical and surgical needs have been met, maximising their recovery and supporting safe transition back to the community.

The extent of the programmes we deliver varies enormously due to the complexity of the brain and the nature and severity of the injury. This diversity and the related complexity of planning and service provision make our work challenging in itself, before even considering the task of commissioning such services.

In such a specialist field, we continue to face two main challenges:

The first is the fact that as a healthcare field, there is still a widespread lack of awareness about exactly who we are and what we do.
This identity crisis manifests itself in many ways, including being shamefully underrepresented at the top table of the NHS, despite the prevalence
of brain injuries, stroke and other neurological disorders.

Part of the issue lies in an in-depth knowledge of patient needs and we feel there is still work to be done with commissioning teams to ensure that longer-term thinking becomes the norm when seeking suitable placements for patients. All too often we see people with neurological conditions spending significantly more time in hospital than necessary; they often live in inappropriate settings such as residential care homes and lead lives of exclusion and isolation.

Ultimately, a good rehabilitation programme will reduce costs in the long term. People will improve more effectively after a period of good 
quality rehabilitation and thus need less care overall. Ultimately, they will also stand a greater chance of returning home and even potentially back to some form of employment.

The second major issue is in convincing commissioners of the cost / value of neurorehabilitation has always been a challenge. There is now a substantial body of trial-based evidence and other research to support both the effectiveness and cost-effectiveness of specialist neurorehabilitation which needs to be constantly communicated. The cost of providing early specialist neurorehabilitation for patients with complex needs is rapidly offset by longer-term savings in the cost of community care, making this a highly cost-efficient intervention.

Our hope is that true integrated funding will become a national reality and health and social care services will be able to join up more effectively. We believe this would have huge impact on our area work in particular and the outlook would certainly improve for patients and their families.

Business Growth

As far as growth and development is concerned, we will continue to look for new opportunities, whether that is offering rehabilitation for new clinical pathways, opening more services or increasing our geographical coverage.

In recent years, we have placed the spotlight firmly on the knowledge and expertise of our clinical leads. Whilst this continues to be fundamental to the high quality of care pathways we are able to offer, the outcomes we strive to deliver are ever-evolving and as such, we anticipate a need to focus more on our therapeutic services in the coming months and years, with a high emphasis on the day-to-day support we provide our patients and focusing on enablement rather than care.

We have a programme in place geared towards gaining CQC ‘outstanding’ across our services; we strongly believe that the companies that are consistently delivering high quality, measureable outcomes are the ones that will continue to thrive in the most challenging of markets. It is our every intention to be a leader in these areas.

In addition to this, we hope to build on the positive relationships we have with those who have previously commissioned our services and the robust outcomes we continue to deliver in successfully rehabilitating and discharging people to their own home or into supported living where necessary – with 86% of our residents are discharged back to their own homes following a period of rehabilitation. We are reminded of the value of our work and how it changes lives on a daily basis and we are looking forward to the challenges ahead!

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