Today, a major new guideline has been published by the National Institute for Health and Care Excellence (NICE). HCML has actively contributed to the development of these guidelines, which provide guidance and recommendations for dealing with complex rehabilitation needs after traumatic injury.
Although largely focused on guidance for the NHS, there is clear recognition of the importance of utilising the broader rehabilitation service sector, spanning both private and third sector services, to coordinate the best care and intervention to help clients regain optimum function and independence.
The guidelines are there to ensure a real difference is made to the lives of people who have complex rehabilitation needs as a result of traumatic injury. This includes:
- Assessment and goal setting
- Rehabilitation programmes that address physical, psychological and cognitive rehabilitation
- A focus on specific injuries and tailored rehabilitation
- Coordination of rehabilitation in hospital, at discharge and in the community
Of key importance are the following areas:
Improving emotional and psychological support
Psychological injury is common after a traumatic injury, as the person comes to terms with the traumatic injuries they’ve suffered. This can result in low mood, anxiety and depression.
Symptoms can be ongoing, and psychological and mental distress can continue to present in different ways throughout rehabilitation, for example as the person adapts to life changing injuries which can hugely affect all aspects of their lives.
The guidelines encourage discussion with the individual on the psychological support available and what would be best for their recovery, as an integral part of their overall rehabilitation programme. Family and carers should be included in decision making if appropriate.
Early intervention to improve quicker access to rehabilitation
Evidence suggests that the earlier the individual starts rehabilitation, the more effective the interventions are. Initial assessment should be undertaken as soon as possible after the traumatic injury, and there should be ongoing involvement of rehabilitation specialists throughout the acute stages, so that the right care and interventions are set up to meet the needs of the individual. For example, some interventions may need to take place before acute treatment such as surgery, in order to maintain other functional ability.
Longer-term rehabilitation goals should be considered as early as possible to ensure all measures are put in place to build a bespoke pathway of recovery for the individual and ultimately achieve these goals.
Of utmost importance is the provision of immediate psychological and emotional support for the individual who are displaying signs of psychological injury. This support is vital to help them come to terms with their injuries and engage as fully as possible in their rehabilitation to ensure the best possible outcomes.
Bespoke rehabilitation programmes in consultation with the client
The guidelines are very clear on adopting a patient-centred approach. When developing a rehabilitation programme and setting goals, it is vital to include the individual (and where appropriate, their families and carers) in decision making, and consider what is important to the individual and what they want to achieve from their rehabilitation.
It’s necessary to understand how the individual sees their lifestyle moving forwards and what can be done to help them achieve this, rather than allowing the nature of the injury to dictate what would generally be considered achievable for these types of injuries.
Focusing on the individual and enabling them to take decisions about their recovery will improve engagement with rehabilitation interventions. Taking small steps and regularly reviewing goals to ensure they’re in line with the individual’s wants and needs will encourage recovery.
For further information, visit the Rehabilitation after traumatic injury section on the NICE website.