A final programme grant report was submitted to the NIHR 2015. The views expressed in the report are those of the authors and not necessarily those of the NIHR or the NHS.
The full UK ROC dataset represents the inpatient rehabilitation subset of the Long-term Neurological Conditions dataset. It comprises demographic information and processes data for each admitted case episode together with the Rehabilitation Complexity Scale (as a measure of rehabilitation needs) and at least one of an agreed set of outcome measures which include the Full dataset - The UK FIM+/-FAM and the Minimum dataset - Barthel Index. They are free and available to all participating sites.
- Allows multiple episodes and assessments per patient
- Records patient details and demographics and episode related information (diagnosis, admission, discharge etc)
- Data input via sequences of dialog boxes or directly on worksheets
- Built in validation checks with visual feedback highlighting errors
- Totals for outcome measures are calculated automatically
- Generates graphs for visualising FIM+/-FAM and NPDS scores
- Automatically pseudonymises data on export
- Includes import facility for migrating data from older versions of software
Join UK ROC
Please email us to register your unit. The UK ROC team will ask you to complete a Service Profile form before sending you a copy of the data collection software and a user guide. Please let us know if you would like further guidance or training. Data collection can start immediately after registration.
The software consists of a macro-enabled Excel Workbook and requires a copy of Office/Excel running on Windows in order to work.
How do we submit data?
Units aspiring to obtain the Level 1 or 2 status submit a psuedonymised export from the database at the end of each month. For more information on how to submit data, submission deadlines and reporting information please contact the UK ROC team.
Related tools and outcome measures
UK ROC provides NHS England (NHSE) with a commissioning dataset for level 1 and 2 specialist rehabilitation services in England. The database collates monthly activity reports returned from all registered services to providers and commissioners for the purpose of contract monitoring. It also provides quality and benchmarking data against the standards set out in the services specification.
The PbR guidance for 2013/14 introduced a multi-level weighted bed day (WBD) commissioning currency for specialist (level 1 and 2) rehabilitation services together with a set of indicative tariffs. Some commissioners have asked for clarification about how the multi-level weighted bed-day currency is implemented in practice with worked examples. The following link will take you to a paper that was developed through the NHSE Clinical Reference Group for Specialist Rehabilitation in 2014/15 to assist providers and commissioners with implementation of the WBD currency.
The weighted bed day currency for specialist rehabilitation (PDF)
Changes in commissioning and financial arrangements for NHS funded services will affect the future provision of specialist rehabilitation services. In February 2021, legislative proposals were produced for a Health and Care Bill in the white paper named ‘Integration and Innovation: working together to improve health and social care for all’. The paper outlines the largest reform of the NHS in more than a decade. It builds on the NHS’ Long Term Plan by promising closer integration health and social care, through the development of Integrated Care Systems (ICSs).
All specialised services, as prescribed in the NHSE regulations, will continue to be subject to consistent national service specifications and evidence-based policies determining treatment eligibility. NHSE will remain responsible for oversight to ensure consistency of access to specialised services across the country. However, it will devolve commissioning of the services to local ICSs. Over time, service specifications are likely to become more outcomes-focused to support innovative and flexible solutions to local circumstances.
Activity based payments through national tariffs are being replaced by block contracts using Aligned Payment and Incentive Agreements (APIA). Future contracts will be negotiated locally and based on local service costs obtained from patient level costing (PLICS), rather than national prices.
The PLICS systems do not include rehabilitation but UK ROC provides the only source of patient level costing information and activity on which such contracts could be based. Data collection and analysis will become even more essential to support commissioning of services in the new local networks and integrated pathway systems.
The Tariff Calculator Tool (XLS) is an Excel spreadsheet that allows for the easy conversion of Occupied Bed Days (OBD's) into the mandated currency of Weighted Bed Days (WBD's).
Please email us if you have any questions.
UK ROC was set up through a Department of Health NIHR Programme Grant to develop a national database for collating case episodes for inpatient rehabilitation.
The first version of the database software was released in 2010 and development has been undertaken in collaboration with the British Society of Rehabilitation Medicine and the Australasian Rehabilitation Outcome Centre. During the first five years, UK ROC focused on neurorehabilitation and ultimately included data from all specialist Level 1 and 2 neurorehabilitation services across the UK.
Levels of specialist services
The Department of Health revised its Specialised Services National Definition Set (SSNDS). The Third Edition definition: No 7 Brain Injury and Complex Rehabilitation, identifies three main levels of service;
- Level 1: Specialised (tertiary) rehabilitation services serving a catchment population > 1 million population and carrying a high proportion of complex cases and reporting the full clinical dataset to the UK ROC database. These will probably be designated by the National Specialised Commissioning Group (NSCG).
- Level 2: Local specialist rehabilitation services serving a population of 250K – 1 million, carrying a lower proportion of complex cases and reporting at least the minimum clinical dataset to the UK ROC database.
- Level 3: Non-specialist rehabilitation services serving a local population (usually <500K) led by therapists or non-Rehabilitation medicine consultants.
- Level 3a: services are local services which ‘specialise’ in certain conditions and include a significant component of rehabilitation (for example stroke, or care of the elderly). They are led/supported by consultants in specialties other than Rehabilitation (e.g. neurology / stroke medicine) and may act as a local source of expertise, even though they do not meet the full standards for a ‘specialist rehabilitation service’.
- Level 3b: services are non-medically led services for example in intermediate care settings.
It has been suggested that Level 2 should be further sub-divided into:
- Level 2a: Supports supra-district catchment population of 750K or more and takes a proportion of patients with very complex needs. Level 2a reports full clinical dataset to the UK ROC database and submits UK ROC data monthly.
- Level 2b: A district service with a catchment population of <750K and has a lower proportion of complex cases. Level 2b services report a minimum dataset to the UK ROC database and submit data monthly.
- Professor Lynne Turner-Stokes, UK ROC Lead
- Heather Williams, Senior Research Fellow
- Lynette George, Senior Research Fellow
- Keith Sephton, Database Manager
- Alan Bill, Programme Accountant
- Dimple Baria, Data Entry Clerk
- Elica Ming-Brown, Therapy Administrative Assistant and Course Co-ordinator