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Rehabilitation scales


The Northwick Park Nursing Dependency tool provides an assessment of patient care needs. It is an ordinal scale incorporating activities of daily living, safety awareness, behavioural management and communication. 

It is designed to measure change for highly dependent patients, and has been used to demonstrate the cost-efficiency of rehabilitation for this group but can also be translated to a Barthel index.

The NPDS translates into the Northwick Park Care Needs Assessment – a directly costable measure of care needs in the community. The NPCNA is derived from the NPDS using a computerised algorithm based on a set of validated 'rules' or assumptions, together with a small additional set of 5 questions about the community setting. The computer outputs include an overall nursing dependency score, an estimation of care hours for each carer and a suggested care package required to meet the care needs. Graphs provide a visual representation of change in care needs, hours and cost.

Whilst the NPDS/NPCNA was developed for use in the rehabilitation setting in the UK, it has also been used in other nursing settings in the UK and abroad.

Further development of the tool has been completed (NPDS-Hospital) and an algorithm for the adapted tool is being developed.The NPCNA is part of the NIHR dataset for Level 1 or Level 2 specialist rehabilitation services. In this context it is normally applied in parallel tranches in conjunction with the therapy assessment (NPTDA). Please contact the NIHR team for further information regarding parallel tranches.

The NPCNA is freely available for use without restriction. In its original form it is completed by a nurse or carer who knows the patient well, although a self-report version is available for use in postal questionnaires. No specific training is required 

See the NPDS - Nursing Dependency Scale/NPCNA - Care Needs Assessment webpage for copies of the instruments and computer programme, or contact:

Heather Williams, Senior Research Fellow.

Regional Hyperacute Rehabilitation Unit,
Northwick Park Hospital, 
Watford Road
HA1 3UJTel 


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