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Research & impact
The UK Rehabilitation Outcomes Collaborative (UK ROC) provides the national clinical registry for specialist rehabilitation.
UK ROC systematically collates patient level data from all the specialist (Level 1 and 2) rehabilitation units in England pertaining to:
Initially developed through a NIHR-funded programme grant (2008-2015), UK ROC is now commissioned by NHS England to provide its commissioning dataset and information on quality benchmarking and outcomes to inform service planning and delivery.
The programme is directed by Professor Lynne Turner-Stokes.
It is overseen by the UK ROC Oversight Group comprising members of the NHSE Clinical Reference Group and the British Society of Physical and Rehabilitation Medicine (BSPRM).
The UK ROC database is hosted by London North-West University Healthcare NHS Trust.
From time to time UK ROC provides reports to assist providers and commissioners with service planning. Find out more for any recent reports.
The full UK ROC dataset represents the inpatient rehabilitation subset of the Long-term Neurological Conditions dataset.
Unit name, code
Designated service level (Level 1a,b,c; Level 2a,b)
Age, date of birth, gender, ethnicity, diagnosis, date of onset
GP, Integrated care board
Response times and processing
Source of referral
Dates of referral, assessment admission discharge
Admitted from, programme of care,
Length of stay,
Interruptions of care (No. days, reason)
Discharge date (anticipated and actual),
Delayed discharges: No. days, reason
Occupied bed days, weighted bed days
Collected at admission and discharge*
Needs for rehabilitation
The Rehabilitation Complexity Scale (RCS-E)
The Patient Categorisation Tool (PCAT)
Inputs provided to meet those needs
The Northwick Park nursing Dependency Scale (NPDS)
The Northwick Park therapy Dependency assessment (NPTDA)
Gains in independence
Reduction of care needs
Individual goal achievement
The UK Functional Assessment Measure (UK FIM+FAM)
The Northwick Park Care Needs Assessment (NPCNA)
Goal Attainment Scaling
The Mayo Portland Adaptability Inventory
The time taken to offset the initial costs of rehabilitation by reduction in the cost of ongoing care needs, as estimated by the Northwick Park Care Needs Assessment
*For more information on each of the above tools, click on the tool name
The UK ROC software that contains collates measures of need, input and outcome is built on Microsoft Excel and is freely available from the UK ROC team: Contact LNWHfirstname.lastname@example.org
In England, rehabilitation services are provided at a number of different levels according to the complexity of need:
The British Society of Physical and Rehabilitation Medicine has provided a detailed description of the different levels of service and their definitions (Specialist neuro-rehabilitation services: providing for patients with complex rehabilitation needs 2015)
Level 1 services are further subdivided into:
Level 2 services are further subdivided into:
1a – High physical dependency
1b – Mixed disability
1c - Cognitive behavioural
2a – Supra district services
2b - Local district services
Between 2013 and 2023:
From April 2024 onwards:
The basis for contracting and commissioning is also changing.
PLICS systems for rehabilitation are still in development.
To support transition, NHSE/I have continued to publish prices and currencies for 2023-25.
For more information on how to submit data, submission deadlines and reporting information please contact the UK ROC team.
Please email us to register your unit.
Manuals and training resources can be found on the web-pages for each of the tools.
A manual for use of the UK ROC software is available.
UK ROC runs regular courses on use of the various tools and data entry:
Email LNWHemail@example.com for details
For more information on the weighted bed day currency, see the following:
For further information about the training programme please contact:
During the NIHR-funded phase of its development, UK ROC collected only de-identified data.
Since it was commissioned by NHSE to provide the national commissioning dataset, UK ROC was mandated to provide identifiable patient level activity data to flow through to the Data Service for Commissioners Regional Offices (DSCROs) for contract and performance monitoring of the various service providers.
In addition, patients with complex disability following severe illness or injury form a vulnerable group of people for whom services are scarce. Clinical care can easily become fragmented as patients move between services (often over a wide geographical area) – and some patients literally get lost in the system.
UK ROC therefore required permission to collect and hold the NHS number for three different purposes - clinical, commissioning and audit.
Working with NHS Digital, NHS England, the Health Research Authority and the Caldicott Guardians for all of the individual services who report data to UK ROC, the relevant permissions have been obtained to collect the NHS number for these three purposes.
Since April 2017, UK ROC collates identifiable patient data, including the NHS number, for all but four of the Level 1/2 services. This information can be used to track individual patients for clinical purposes.
The National clinical guidelines for Prolonged Disorders of Consciousness 2020 recommended creation of a registry of patients in PDOC.
From 2023/4, the UK ROC database will include the national PDOC Registry.
The purposes of the registry are:
Data linkage using the NHS number for the purpose of clinical audit requires permission from the Health Research Authority Clinical Advisory Group (HRA-CAG) under Section 251.
So far this has been obtained for one major national project – the National Clinical Audit for Specialist Rehabilitation following major Injury (NCASRI), which linked UK ROC data with that from the Trauma Audit and Research Network (TARN) to determine whether patients who required ongoing specialist inpatient rehabilitation on leaving the major trauma centres were able to access the services they required.
Future data linkage with other acute datasets will require separate s251 permissions.
UK ROC is an important source of health service research in rehabilitation.
For publications on the development and validation of individual measure tools please see the relevant tools pages.
Some key publications from the UK ROC programme are as follows:
Turner-Stokes L, Williams H, Bill A, Bassett P, Sephton K. Cost-efficiency of specialist inpatient rehabilitation for working-aged adults with complex neurological disabilities: A multicentre cohort analysis of a national clinical dataset BMJ Open 2016 Feb 24;6(2):e010238. doi: 10.1136/bmjopen-2015-010238
Turner-Stokes L, Bavikatte G, Williams H, Bill A, Sephton K. Cost-efficiency of specialist hyperacute in-patient rehabilitation services for medically unstable patients with complex rehabilitation needs: a prospective cohort analysis. BMJ Open. 2016 Sep 8;6(9):e012112. doi: 10.1136/bmjopen-2016-012112.
Turner-Stokes L, Dzingina M, Shavelle R, Bill A, Williams H, Sephton K Estimated life-time savings in the cost of on-going care following specialist rehabilitation for severe traumatic brain injury in the UK. Journal of Head Trauma Rehabilitation. doi:10.1097/HTR.0000000000000473. PMID: 30801440
Turner-Stokes L, Harding R, Peihan Y, Dzingina M, Wei G Cost-efficiency of specialist inpatient rehabilitation for adults with multiple sclerosis: A multicentre prospective cohort analysis of a national clinical dataset Multiple Sclerosis Journal – Experimental, Translational and Clinical. 2020 Mar 16;6(1):2055217320912789. doi: 10.1177/2055217320912789. eCollection 2020 Jan-Mar.
Turner-Stokes L, LeFeuillee G, Francis R, Nayar M, Nair N. Functional outcomes and cost-efficiency of specialist in-patient rehabilitation following spinal cord injury: A multi-centre national cohort analysis from the UK Rehabilitation Outcomes Collaborative (UK ROC) Disability and Rehabilitation. 2021 Jul 20;1-9. doi: 10.1080/09638288.2021.1946603.
Turner-Stokes L, Rose H, Knight A, Williams H, Siegert RJ, Ashford SA. Prolonged disorders of consciousness: identification using the UK FIM + FAM and cohort analysis of outcomes from a UK national clinical database. Disabil Rehabil. 2022 Feb 15:1-10. doi: 10.1080/09638288.2022.2037754. Epub ahead of print. PMID: 35166637
Turner-Stokes L, Williams H, Sephton K, Rose H, Harris S, Thu A. Engaging the hearts and minds of clinicians in outcome measurement – the UK Rehabilitation Outcomes Collaborative approach. Disability and Rehabilitation. 2012: 34(22); 1871-9
Singh R, Sinha S, Bill A, Turner-Stokes L. Unmet need for specialised rehabilitation following neurosurgery: can we maximise the potential cost–benefits? Brit J Neurosurg 2017; 31(2):249-253. doi: 10.1080/02688697.2016.1233318
Turner-Stokes L, Poppleton R, Williams H, Schoewenaars K, Badwan, D. Using the UK ROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation. Disability and Rehabilitation 2012: 34(22); 1900-6
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