The Blog

Specialist Care and Rehabilitation: When Will Funders Understand How Can We Square the Circle?

There was a wonderful moment when we officially opened our flagship neurological care centre, Eagle Wood. TV presenter and actor Sir Tony Robinson took a tour of the centre and declared:

I just wish Eagle Wood was replicated in every other town and city across the country. It's important to celebrate best practice. And Eagle Wood is just the best practice you could possibly have.

Eagle Wood in Peterborough is the only UK centre of its kind providing onsite care and treatment for all neurological care conditions. We treat people with a range of conditions, including motor neurone disease, young onset dementia and Huntington's disease, as well as some spinal and acquired brain injuries.

Why more specialist care is so important

The type of specialised care offered by PJ Care is vitally needed in the UK. Steady and on-going medical advances mean the prognosis for people who suffer a serious brain injury is significantly better now than 20 years ago. Someone who suffers a sports injury, is in a traffic accident, or is hurt at work is much more likely to survive with little reduction in their life expectancy. But at the same time, we have experienced how savage cuts in rehabilitation services have affected individuals who are in our care.

How can we square the circle? More people are requiring specialised treatment and rehabilitation, but at the same time funding is being cut.

Well the answer is clear - and so is the evidence. More specialised treatment, not less, is the only cost-effective way forward. Not providing the appropriate levels of rehabilitation for people with neurological conditions will ultimately cost the taxpayer more money in the long run. Short-term, short-sighted decisions on this issue - as all the evidence shows - are not helpful.

Specialist treatment is cost-effective treatment

A recent survey by brain injury charity Headway UK suggested more than a million people with a brain injury living in the UK had been forced to compromise their quality of life because a combination of local authority, NHS funding and welfare budget reforms has resulted in rehabilitation and support services being removed.

More than half of the 500 survivors of brain injury in the survey reported that they had lost access to rehabilitation and support services. The evidence, of course, is that the cuts were not cost effective. People who don't receive the appropriate rehabilitation are actually forced to become dependent on more expensive, long-term state support in the future.

Although specialist rehabilitation may in the short term cost more to funders than a person going home, on-going savings are made because that person requires less support in the long run. That means it's cheaper for the NHS - cheaper for all of us who are paying taxes.

As well as helping people to recover skills lost through brain injury, quality rehabilitation has been shown to save between £200,000 and £1.13 million in lifetime care costs per patient, according to peer-reviewed research by the Brain Injury Rehabilitation Trust (BIRT) in September 2013.

Professor Rodger Wood from Swansea University is another advocate of specialist rehabilitation units for patients after they leave hospital, saying they can save millions every year in care costs. He said:

Around 500 people per year (in the UK) will have permanent and serious neuro-behaviour disabilities as a result of head trauma. If you think of that year on year the number of people is growing and the level of services for them is still very, very poor. It's been estimated that people who go through post-acute rehabilitation make the kind of improvements that save millions of pounds per year in care costs - that's contact with GPs, contact with hospital authorities, social services support and all the rest of it

Multi-disciplinary teams key to quality care

Specialist rehabilitation is an issue that needs urgent attention. Every 90 seconds someone in the UK suffers a brain injury. There can be many causes, such as a bleed to the brain, a fall, an assault - often it is the result of a road accident.

In these situations, the brain has to rebuild pathways to allow the person who has suffered the injury to re-learn the things they once took for granted, and that is why specialist rehabilitation and appropriate quality care are so vital.

Other neurological conditions mean more than a million people in the UK are disabled and need care and rehabilitation.

Every day at our three neurological care centres we see how specialist rehabilitation provided by a multi-disciplinary team provides top quality care.

The True Cost of Short-Term Funding Cuts

John, a successful and well known freelance photographer, had a serious car crash in 2013, breaking nearly every bone on his right side of his body.

After weeks in an NHS Intensive Care Unit he was transferred to Eagle Wood, our Neurological Care and Rehabilitation Centre in Peterborough. Our Multi- Disciplinary Team, made up of a Neuro-Rehab Consultant, Psychiatrist, Neuro Psychologist, Physiotherapists, Occupational Therapists, Speech and Language Therapist, Dietician and highly trained rehab nursing staff started working with John and for eight months teaching him to walk again and to use his right arm.

On a daily basis one could see how this once broken man was improving. He was getting his confidence back, he started to walk again and mentally he was motivated to go back home and continue his career.

But sadly this came all to a sudden and unexpected end when a commissioner decided to draw a line under his case and not continue with his rehabilitation funding. The family of John and our company fought to retain his funding for a couple of months more to get John back to the community as a man that could live independently and go back to his career. The answer was "no" from the commissioning group and they even raised a safeguarding against me as the CEO of the company as I was allegedly "profiteering from a vulnerable man".

The crux of this story is that before his funding was cut, John could walk with the aid of a walking stick from his room in the rehabilitation unit to the front door of the centre which is at least 70 yards. Denied of the intensive rehabilitation therapy he needed, John is home but is bound to his wheelchair, cannot work and is reliant on domiciliary care.

His total weekly fee with us at the time was £1911 per week. Now, his personal social services budget is £4000 per week which he will receive for the rest of his life. All he needed was 6 more months in a rehabilitation unit and he would have been able to live and work independently.