PCAT - Patient Categorisation Tool
There is wide variation in the level of complexity following an acquired brain injury. To ensure patients receive the level of care required in the right setting an assessment of need is required. The NHSE service specification identifies 4 categories of need (A, B, C & D) based on selected criteria.
The Patient categorisation tool was initially developed as a checklist to assist in identifying patients with complex needs requiring treatment in Level 1 (tertiary) inpatient rehabilitation services and then was further developed as an ordinal scale to identify category A, B or C/D needs.
The description for each category listed in the NHSE service specification has been included in the tool. The tool comprises of 18 domains each with 3 columns containing level of need divided into Category A, B or C/D needs. In addition to the domains, there are supplementary questions based on clinical impression on the service level required, potential category of need and estimated duration of in-patient rehabilitation stay.
The PCAT is scored once on admission (ideally by the Consultant in rehabilitation medicine or their deputy). Completion of the tool consists of “ticking” the descriptions applicable for each domain and the supplementary questions.
Each domain is rated on a score of 1-3 (highest score applied once to each domain). Only the highest of either the medical/neuropsychiatric scores is included (not both scores) and the “duration of stay” is allocated a score of 0-2. So the final tool is a 17 item scale with a total score range of 16-50
The category of need currently remains a clinical decision; however, there is reasonable indication that a total PCAT score of 19-24 indicates Category C needs, 25-29 category B needs and a total PCAT score of ≥30 category A needs.
The PCAT is a mandatory UK ROC requirement and the information is captured within the UK ROC software.
Collaborative work is in progress with Western Australia to develop the PCAT-Oz
Self-learning slides are available here
PCAT tool is available here