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Community Rehabilitation Service Delivery

Funded by the NIHR SDO programme now entitled Health Services and Delivery Research Programme (HS&DR), this project entitled Community Rehabilitation Service Delivery in Long Term Neurological Conditions (Ref: HS&DR 08/1809/235) was conducted in our department between 2009-2013.


Principal investigators
  • Professor Richard Siegert
  • Professor Lynne Turner-Stokes
  • Dr Paul McCrone
  • Dr Diana Jackson
  • Dr Paul Basset
  • Dr Diane Playford
  • Dr Simon Fleminger


Brief overview

The National Service Framework (NSF) for Long-Term Neurological Conditions (LTNCs) emphasises the need to place patients and families at the centre of service provision, and promotes integrated community-based services focused on a person-centred model of service delivery.

A previous report funded by the NIHR SDO programme (Gladman 2007) demonstrated that community services for LTNCs were fragmented or missing. Particular gaps were highlighted in services for people with cognitive deficits and/or challenging behaviours.

Given the life-long nature of LTNC, it is critical to be able to identify and track patients via longitudinal data collection. The NSF for LTNC Expert Reference Panel therefore recommended the development of: (a) a LTNC register to identify patients with complex needs and (b) a dataset to support long-term follow-up by monitoring their changing needs over time and the support services they receive.

The register and dataset have the potential to provide benchmarking of service provision and ‘practice-based evidence' for the effectiveness of interventions on a national scale. But before data can be collected in routine clinical practice, the data collection tools must be made fit for purpose. Further, to gather prospective information on service costs and cost benefits, we need simple and practical tools to collate these data.



The purpose of the study was to refine the LTNC register and its associated dataset, and then to use this in a pilot study to examine the extent to which patients’ current needs for health and social services were met, to identify any gaps in service provision, and to examine the extent to which meeting their needs might lead to improved outcomes. We also examined the health economic aspects of met and unmet health and social care needs.


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