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Evaluating and improving care

Complex disability

Disabling conditions may present a range of challenges including ohysical, cognitive, communicative, emptional, and psychosocial disabilities.

Rehabilitation is a process of assessment, treatment and management by which the individual (and their family / carers) are supported to achieve their maximum potential for physical, cognitive, social and psychological function, participation in society and quality of living. Patient goals for rehabilitation vary according to the recovery trajectory and stage of their condition.

Rehabilitation interventions may take a variety of forms ranging from focal treatment of specific symptoms to holistic multi-disciplinary rehabilitation.Our research focuses on the challenges faced by patients and their families living with complex disabilities, requiring specialist rehabilitation

Key areas of our research interest are:

Outcome evaluation:

We have developed a range of tools and scales for measuring rehabilitation needs, inputs and outcomes in rehabilitation.

We have established the UK Rehabilitation Outcomes Collaboration which hosts the national clinical database for rehabilitation. The UKROC database collates information in needs, inputs and outcomes for all patients admitted to specialist (level 1 and 2) rehabilitation services in England. It provides benchmarking information on service quality and serves as the national commissioning dataset for services commissioned by NHS England.

Symptoms

We have developed integrated care pathways for management of symptoms such as pain, depression and spasticity – including tools that assist patients with cognitive / communicative deficits to report their symptoms.

 

Carers’ experiences

We have conducted three major national surveys, using both qualitative and quantitative techniques to evaluate the experience of caring for someone with a long term condition and resulting carer burden – including health economic analyses.We compare the experience of caring for a younger adult with acquired brain injury what that of caring for someone with dementia. We have examined the impact of caring for people who have multiple caring roles and also explored people’s experiences of and needs for replacement care. 

 

Systematic reviews

Working in partnership with a group led by Dr Fary Khan at the Royal Melbourne Hospital, Australia, we have a series of Cochrane and other systematic reviews that summarise the evidence base for multidisciplinary rehabilitation in a variety of conditions.

 

Clinical standards and guidelines in rehabilitation

Working closely with partners such as the British Society of Rehabilitation Medicine (BSRM), Royal College of Physicians and Chartered Society of Physiotherapists we have led the development of a number of key evidence-based standards and guidelines that have improved the quality of care for disabled patients and their families.

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