Complex rehabilitation case management

Capturing the impact of case management within the NHS England complex rehabilitation pathway in the South West

Patients who are admitted to acute hospital following a brain or spinal cord injury may require specialist in-patient rehabilitation to treat and manage their complex disabilities.

NHS England funds highly specialised in-patient rehabilitation services in dedicated regional rehabilitation units, delivered by a team of highly specialised doctors, nurses and allied health professionals.

Over the years the demand for these services had continued to grow, resulting in patient flow pressures within the acute hospitals. Although additional beds had been procured the problem continued to grow, with little real understanding in the system of the root cause of the problem and whether the capacity issues were real or apparent.

In September 2016 and January 2017 (fixed term until December 2017), two case managers were appointed to address these issues in the South West and to provide clinical support and guidance, supporting the South West NHS England commissioners to provide robust clinical intelligence to their contracting process.

This impact story details the how the case management approach has worked in the South West, using an Impact Framework developed by NHS England’s Sustainable Improvement team.