CINXE.COM

<!DOCTYPE html>   <html class="no-js" lang="en" dir="ltr">  <head> <meta name="viewport" content="width=device-width, initial-scale=1"> <link rel="apple-touch-icon" sizes="180x180" href="/sites/all/themes/bgs/icons/apple-touch-icon.png"> <link rel="icon" type="image/png" href="/sites/all/themes/bgs/icons/favicon-32x32.png" sizes="32x32"> <link rel="icon" type="image/png" href="/sites/all/themes/bgs/icons/favicon-16x16.png" sizes="16x16"> <link rel="manifest" href="/sites/all/themes/bgs/icons/manifest.json"> <link rel="mask-icon" href="/sites/all/themes/bgs/icons/safari-pinned-tab.svg" color="#642f6c"> <meta name="msapplication-TileColor" content="#642f6c"> <meta name="theme-color" content="#642f6c"> <script src="https://use.typekit.net/qpa3efa.js"></script> <script>try{Typekit.load({ async: true });}catch(e){}</script>  <link rel="preconnect" href="//www.googletagmanager.com" /> <link rel="dns-prefetch" href="//www.googletagmanager.com" /> <meta charset="utf-8" /> <meta name="viewport" content="width=device-width, initial-scale=1" /> <script src="https://www.google.com/recaptcha/api.js?hl=en" async="async" defer="defer"></script> <meta name="description" content="This chapter looks at the workforce, training and physical space requirements for the delivery of rehabilitation, and considers some solutions to existing barriers." /> <meta name="abstract" content="This chapter looks at the workforce, training and physical space requirements for the delivery of rehabilitation, and considers some solutions to existing barriers." /> <link rel="canonical" href="https://www.bgs.org.uk/resources/reablement-rehabilitation-recovery-chapter-four-building-our-capacity-and-capability" /> <link rel="shortlink" href="https://www.bgs.org.uk/node/7475" /> <meta http-equiv="content-language" content="en" /> <meta property="og:site_name" content="British Geriatrics Society" /> <meta property="og:title" content="Reablement, Rehabilitation, Recovery: Chapter four - Building our capacity and capability | British Geriatrics Society" /> <meta property="og:description" content="This chapter looks at the workforce, training and physical space requirements for the delivery of rehabilitation, and considers some solutions to existing barriers." /> <meta name="twitter:card" content="summary_large_image" /> <meta name="twitter:url" content="https://www.bgs.org.uk/resources/reablement-rehabilitation-recovery-chapter-four-building-our-capacity-and-capability" /> <meta name="twitter:title" content="Reablement, Rehabilitation, Recovery: Chapter four - Building our" /> <meta name="twitter:description" content="This chapter looks at the workforce, training and physical space requirements for the delivery of rehabilitation, and considers some solutions to existing barriers." /> <title>Reablement, Rehabilitation, Recovery: Chapter four - Building our capacity and capability | British Geriatrics Society</title> <style type="text/css" media="all"> @import url("/modules/system/system.base.css?sn052y"); @import url("/modules/system/system.theme.css?sn052y"); </style> <style type="text/css" media="all"> @import url("/modules/comment/comment.css?sn052y"); @import url("/sites/all/modules/date/date_api/date.css?sn052y"); @import url("/sites/all/modules/date/date_popup/themes/datepicker.1.7.css?sn052y"); @import url("/modules/field/theme/field.css?sn052y"); @import url("/sites/all/modules/fitvids/fitvids.css?sn052y"); @import url("/modules/node/node.css?sn052y"); @import url("/sites/all/modules/picture/picture_wysiwyg.css?sn052y"); @import url("/modules/search/search.css?sn052y"); @import url("/sites/all/modules/simpleads/simpleads.css?sn052y"); @import url("/modules/user/user.css?sn052y"); @import url("/sites/all/modules/extlink/extlink.css?sn052y"); @import url("/sites/all/modules/views/css/views.css?sn052y"); </style> <style type="text/css" media="all"> @import url("/sites/all/modules/ctools/css/ctools.css?sn052y"); @import url("/sites/all/libraries/photoswipe/dist/photoswipe.css?sn052y"); @import url("/sites/all/libraries/photoswipe/dist/default-skin/default-skin.css?sn052y"); @import url("/sites/all/modules/civicrm/css/crm-i.css?sn052y"); @import url("/sites/all/modules/civicrm/css/civicrm.css?sn052y"); @import url("/sites/all/modules/webform/css/webform.css?sn052y"); @import url("/sites/all/modules/hide_submit/css/ladda-themeless.min.css?sn052y"); @import url("/sites/all/modules/hide_submit/css/hide_submit.css?sn052y"); </style> <style type="text/css" media="all"> @import url("/sites/all/themes/bgs/css/magnific-popup.css?sn052y"); @import url("/sites/all/themes/bgs/css/bgs.css?sn052y"); @import url("/sites/all/themes/bgs/css/vedacustom.css?sn052y"); </style> <script type="text/javascript" src="/sites/all/modules/jquery_update/replace/jquery/1.9/jquery.js?v=1.9.1"></script> <script type="text/javascript" src="/misc/jquery-extend-3.4.0.js?v=1.9.1"></script> <script type="text/javascript" src="/misc/jquery-html-prefilter-3.5.0-backport.js?v=1.9.1"></script> <script type="text/javascript" src="/misc/jquery.once.js?v=1.2"></script> <script type="text/javascript" src="/misc/drupal.js?sn052y"></script> <script type="text/javascript" src="/sites/all/libraries/fitvids/jquery.fitvids.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/highcharttable/js/highcharttable.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/jquery_update/replace/ui/external/jquery.cookie.js?v=67fb34f6a866c40d0570"></script> <script type="text/javascript" src="/sites/all/modules/jquery_update/replace/misc/jquery.form.js?v=2.69"></script> <script type="text/javascript" src="/misc/ajax.js?v=7.74"></script> <script type="text/javascript" src="/sites/all/modules/jquery_update/js/jquery_update.js?v=0.0.1"></script> <script type="text/javascript" src="/sites/all/modules/admin_menu/admin_devel/admin_devel.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/fitvids/fitvids.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/simpleads/simpleads.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/spamspan/spamspan.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/extlink/extlink.js?sn052y"></script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript" src="/sites/all/modules/iframe/iframe.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/views/js/base.js?sn052y"></script> <script type="text/javascript" src="/misc/progress.js?v=7.74"></script> <script type="text/javascript" src="/sites/all/modules/captcha/captcha.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/webform_conditional/webform_conditional.js?sn052y"></script> <script type="text/javascript" src="/sites/all/libraries/photoswipe/dist/photoswipe.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/libraries/photoswipe/dist/photoswipe-ui-default.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/google_analytics/googleanalytics.js?sn052y"></script> <script type="text/javascript" async="async" src="https://www.googletagmanager.com/gtag/js?id=UA-47703711-1"></script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript" src="/sites/all/libraries/highcharts/js/highcharts.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/highcharttable/libraries/variants/jquery.highchartTable-patched.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/views/js/ajax_view.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/webform/js/webform.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/hide_submit/js/hide_submit.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/hide_submit/js/spin.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/hide_submit/js/ladda.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/jquery.smartmenus.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/jquery.matchheight.mod.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/slick/slick.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/js.cookie.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/resizesensor.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/jquery.navscroll.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/jquery.sticky-sidebar.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/jquery.magnific-popup.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/jquery.shorten.min.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/jquery.shorten.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/scripts.js?sn052y"></script> <script type="text/javascript" src="/sites/all/themes/bgs/js/bgs.behaviour.js?sn052y"></script> <script type="text/javascript"> <![CDATA[//><!]]> </script> </head> <body class="html not-front not-logged-in two-sidebars page-node page-node- page-node-7475 node-type-resource sticky-sidebars i18n-en british-geriatrics-society bgs-org-uk role-anonymous-user menu-depth-2" > <script id="_informizely_script_tag" type="text/javascript"> var IzWidget = IzWidget || {}; (function (d) { var scriptElement = d.createElement('script'); scriptElement.type = 'text/javascript'; scriptElement.async = true; scriptElement.src = "https://insitez.blob.core.windows.net/site/d80f25f3-2290-42a7-a35f-837905591d26.js"; var node = d.getElementById('_informizely_script_tag'); node.parentNode.insertBefore(scriptElement, node); })(document); </script> <noscript><a href="https://www.informizely.com/">Informizely customer feedback surveys</a></noscript> <div role="document" class="page"> <header id="site-header"> <div class="header-outer-wrapper"> <div class="header-inner-wrapper"> <div class="wrapper-site-branding"> <div class="site-branding"> <h2 class="site-title"> <a href="/" title="Home" rel="home"><span>British Geriatrics Society</span></a> </h2> </div> </div> <div class="wrapper-region-header"> <section class="block block-menu"> <ul class="menu"><li class="first leaf"><a href="/about/become-a-member-of-the-bgs" title="">Join</a></li> <li class="leaf"><a href="/user/register" title="">Join</a></li> <li class="last leaf"><a href="/user/login?current=node/7475" title="">Login</a></li> </ul> </section> <section class="block block-views"> <div class="view view-header-sections view-id-header_sections view-display-id-social view-display-grid view-dom-id-9054ffcdf0dce021891018e6a808d833"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first views-row-last section-row -field-row -field-palette"> <div class="card-follow-us-on"> <div class="item-list"><ul><li class="first"><div class='card-links'><a href="https://facebook.com/BGS1947" rel="nofollow" target="_blank">Facebook</a> </div></li> <li><div class='card-links'><a href="https://twitter.com/GeriSoc" rel="nofollow" target="_blank">Twitter</a> </div></li> <li class="last"><div class='card-links'><a href="http://linkedin.com/company/british-geriatrics-society" rel="nofollow" target="_blank">LinkedIn</a> </div></li> </ul></div> </div> </div> </div> </div> </section> </div> </div> <div class="main-nav-wrapper"> <nav id="main-navigation" class="main-navigation"> <section class="block block-menu-block"> <div class="menu-block-wrapper menu-block-1 menu-name-main-menu parent-mlid-0 menu-level-1"> <input id="main-menu-state" type="checkbox" /><label class="main-menu-btn" for="main-menu-state"><span class="main-menu-btn-icon"></span> Toggle main menu visibility</label> <ul class="menu"><li class="first expanded menu-mlid-9196"><a href="/bgs-elearning">BGS elearning</a><ul class="menu"><li class="first leaf menu-mlid-9198"><a href="https://www.bgs.org.uk/elearning/delirium-in-older-people-elearning" title="">Delirium elearning</a></li> <li class="leaf menu-mlid-9197"><a href="https://www.bgs.org.uk/elearning/frailty-elearning-course" title="">Frailty elearning</a></li> <li class="last leaf menu-mlid-9216"><a href="/elearning/oncogeriatrics-elearning-0">Oncogeriatrics elearning</a></li> </ul></li> <li class="leaf menu-mlid-6697"><a href="/about/become-a-member-of-the-bgs" title="">Join BGS</a></li> <li class="leaf menu-mlid-3618"><a href="/blog" title="">Blog</a></li> <li class="expanded menu-mlid-6766"><a href="/events">Events</a><ul class="menu"><li class="first leaf menu-mlid-6835"><a href="/events" title="">Upcoming events</a></li> <li class="leaf menu-mlid-8769"><a href="/abstracts">Abstract submission</a></li> <li class="leaf menu-mlid-9165"><a href="/funded">Funded places</a></li> <li class="leaf menu-mlid-9098"><a href="/events/hybrid-event-faqs">Hybrid Event FAQs</a></li> <li class="leaf menu-mlid-6827"><a href="/events/past-events" title="">On Demand and Past events</a></li> <li class="leaf menu-mlid-8771"><a href="/events/sponsorship" title="Sponsorship Opportunities">Sponsorship</a></li> <li class="expanded menu-mlid-6830"><a href="/events/external-events">External events</a><ul class="menu"><li class="first last leaf menu-mlid-9195"><a href="/events/external-events/add-an-external-event">Add an external event</a></li> </ul></li> <li class="last expanded menu-mlid-6829"><a href="/events/external-courses" title="">External courses and examinations</a><ul class="menu"><li class="first leaf menu-mlid-6844"><a href="/events/external-courses/add-an-external-course">Add an external course</a></li> <li class="last leaf menu-mlid-9140"><a href="/DGM">Diploma in Geriatric Medicine (DGM)</a></li> </ul></li> </ul></li> <li class="expanded menu-mlid-3631"><a href="/policy-and-media" title="">News & Policy</a><ul class="menu"><li class="first leaf menu-mlid-9112"><a href="/policy-and-media/news-policy">Latest news and policy</a></li> <li class="leaf menu-mlid-9215"><a href="/choose">#ChooseGeriatrics</a></li> <li class="last leaf menu-mlid-9147"><a href="https://www.bgs.org.uk/campaigns" title="">Campaigns</a></li> </ul></li> <li class="expanded active-trail menu-mlid-3334"><a href="/resources" class="active-trail">Resources</a><ul class="menu"><li class="first expanded menu-mlid-9186"><a href="/resources/bgs-hubs">BGS Hubs</a><ul class="menu"><li class="first leaf menu-mlid-9187"><a href="/node/5805/" title="">Frailty Hub</a></li> <li class="leaf menu-mlid-9188"><a href="/deliriumhub" title="">Delirium Hub</a></li> <li class="leaf menu-mlid-9189"><a href="/QIHub" title="">QI Hub</a></li> <li class="last leaf menu-mlid-9190"><a href="/research" title="">Research Hub</a></li> </ul></li> <li class="leaf menu-mlid-3704"><a href="/resources/resource-series">Resources by series</a></li> <li class="expanded menu-mlid-3706"><a href="/resources/topics">Resources by topic</a><ul class="menu"><li class="first expanded menu-mlid-8776"><a href="http://www.bgs.org.uk/covid-19" title="">COVID</a><ul class="menu"><li class="first leaf menu-mlid-8777"><a href="https://www.bgs.org.uk/resources/resource-series/coronavirus-and-older-people" title="">For healthcare professionals</a></li> <li class="leaf menu-mlid-8778"><a href="https://www.bgs.org.uk/coronavirus-advice-to-older-people" title="">For the public</a></li> <li class="leaf menu-mlid-8779"><a href="https://www.bgs.org.uk/media-enquiries" title="">Media enquiries</a></li> <li class="last leaf menu-mlid-9101"><a href="/http%3A/www.bgs.org.uk/covid-19/covid-19-research">Research and trials</a></li> </ul></li> <li class="expanded menu-mlid-5651"><a href="/topics/acute-care" title="Acute Care">Acute Care</a><ul class="menu"><li class="first leaf menu-mlid-5653"><a href="/topics/deconditioning-rehabilitation" title="Deconditioning">Deconditioning</a></li> <li class="leaf menu-mlid-5656"><a href="/topics/emergency-care" title="Emergency care">Emergency care</a></li> <li class="leaf menu-mlid-5657"><a href="/topics/end-of-life-care" title="End of life care">End of life care</a></li> <li class="leaf menu-mlid-5658"><a href="/topics/patient-safety" title="Patient safety">Patient safety</a></li> <li class="leaf menu-mlid-5659"><a href="/topics/patientfamily-involvement" title="Patient/Family Involvement">Patient/Family Involvement</a></li> <li class="leaf menu-mlid-5655"><a href="/topics/peri-operative-care-for-surgical-patients" title="Peri-operative care for surgical patients">Peri-operative care for surgical patients</a></li> <li class="last leaf menu-mlid-5652"><a href="/topics/cga-in-acute-settings" title="Comprehensive Geriatric Assessment (CGA) in acute settings">Comprehensive Geriatric Assessment (CGA) in acute settings</a></li> </ul></li> <li class="expanded menu-mlid-5660"><a href="/topics/primary-and-community-care" title="Primary and Community Care">Primary and Community Care</a><ul class="menu"><li class="first leaf menu-mlid-9109"><a href="/topics/care-homes" title="Care Homes">Care Homes</a></li> <li class="leaf menu-mlid-5662"><a href="/topics/commissioning" title="Commissioning">Commissioning</a></li> <li class="leaf menu-mlid-5664"><a href="/topics/healthy-ageing" title="Healthy Ageing">Healthy Ageing</a></li> <li class="leaf menu-mlid-6968"><a href="/topics/transfer-of-care" title="Transfer of Care">Transfer of Care</a></li> <li class="leaf menu-mlid-5661"><a href="/topics/cga-in-community-settings" title="Comprehensive Geriatric Assessment (CGA) in community settings">Comprehensive Geriatric Assessment (CGA) in community settings</a></li> <li class="leaf menu-mlid-5667"><a href="/topics/digital-health-ampamp-technology" title="Digital Health and Technology">Digital Health and Technology</a></li> <li class="last leaf menu-mlid-5707"><a href="/topics/eyes-and-ears" title="Eyes, Ears and Teeth">Eyes, Ears and Teeth</a></li> </ul></li> <li class="expanded menu-mlid-7717"><a href="/topics/cross-cutting-primaryacute" title="Cross-cutting Primary/Acute">Cross-cutting Primary/Acute</a><ul class="menu"><li class="first leaf menu-mlid-5654"><a href="/topics/dignity" title="Dignity">Dignity</a></li> <li class="leaf menu-mlid-5663"><a href="/topics/frailty-indexes" title="Frailty indexes">Frailty indexes</a></li> <li class="leaf menu-mlid-5665"><a href="/topics/integrated-care" title="Integrated care">Integrated care</a></li> <li class="leaf menu-mlid-9110"><a href="/topics/rehabilitation" title="Rehabilitation">Rehabilitation</a></li> <li class="last leaf menu-mlid-5666"><a href="/topics/prescribing%20and%20medication%20management" title="Prescribing and medication management">Prescribing and medication management</a></li> </ul></li> <li class="expanded menu-mlid-9172"><a href="/topics/clinical-quality" title="Clinical Quality">Clinical Quality</a><ul class="menu"><li class="first leaf menu-mlid-9173"><a href="/topics/quality-improvement" title="Quality Improvement">Quality Improvement</a></li> <li class="last leaf menu-mlid-9185"><a href="/QIHub" title="">QI Hub</a></li> </ul></li> <li class="expanded menu-mlid-5695"><a href="/topics/research" title="Research">Research</a><ul class="menu"><li class="first leaf menu-mlid-6861"><a href="/topics/grants-fellowships-and-research-proposals" title="Grants, Fellowships and Research Proposals">Grants, Fellowships and Research Proposals</a></li> <li class="last leaf menu-mlid-9184"><a href="/research" title="">Research Hub</a></li> </ul></li> <li class="expanded menu-mlid-5685"><a href="/topics/general" title="General">General</a><ul class="menu"><li class="first leaf menu-mlid-5687"><a href="/topics/allied-healthcare-professionals" title="Allied Healthcare Professionals">Allied Health Professionals</a></li> <li class="leaf menu-mlid-5688"><a href="/topics/demographics" title="demographics">Demographics</a></li> <li class="leaf menu-mlid-5689"><a href="/topics/education-training-and-careers" title="Education, Training and Careers">Education, Training and Careers</a></li> <li class="leaf menu-mlid-5690"><a href="/topics/ethics-and-law" title="Ethics and Law">Ethics and Law</a></li> <li class="leaf menu-mlid-5691"><a href="/topics/health-and-social-care-policy" title="Health and social care policy">Health and social care policy</a></li> <li class="leaf menu-mlid-5692"><a href="/topics/history-of-geriatric-medicine" title="History of Geriatric medicine">History of Geriatric medicine</a></li> <li class="leaf menu-mlid-5693"><a href="/topics/nice-guidelines" title="NICE guidelines">NICE guidelines</a></li> <li class="leaf menu-mlid-5694"><a href="/topics/nursing" title="Nursing">Nursing</a></li> <li class="leaf menu-mlid-5696"><a href="/topics/workforce" title="Workforce">Workforce</a></li> <li class="last leaf menu-mlid-9116"><a href="/topics/wellbeing" title="Wellbeing">Wellbeing</a></li> </ul></li> <li class="expanded menu-mlid-5668"><a href="/topics/specific-conditions" title="Specific conditions">Specific conditions</a><ul class="menu"><li class="first leaf menu-mlid-5669"><a href="/topics/balance-disorders" title="Balance disorders">Balance disorders</a></li> <li class="leaf menu-mlid-5672"><a href="/topics/continence" title="Continence">Continence</a></li> <li class="leaf menu-mlid-9111"><a href="/topics/covid-19" title="COVID-19">COVID-19</a></li> <li class="leaf menu-mlid-5673"><a href="/topics/delirium" title="Delirium">Delirium</a></li> <li class="leaf menu-mlid-5674"><a href="/topics/dementia" title="Dementia">Dementia</a></li> <li class="leaf menu-mlid-5677"><a href="/topics/frailty" title="Frailty">Frailty</a></li> <li class="leaf menu-mlid-5678"><a href="/topics/mental-health" title="Mental Health">Mental Health</a></li> <li class="leaf menu-mlid-5679"><a href="/topics/movement-disorders" title="Movement Disorders including Parkinsons">Movement Disorders including Parkinsons</a></li> <li class="leaf menu-mlid-5680"><a href="/topics/multimorbidity" title="Multimorbidity">Multimorbidity</a></li> <li class="leaf menu-mlid-5681"><a href="/topics/nutrition" title="Nutrition">Nutrition</a></li> <li class="leaf menu-mlid-5682"><a href="/topics/pain" title="Pain">Pain</a></li> <li class="leaf menu-mlid-5683"><a href="/topics/stroke" title="Stroke">Stroke</a></li> <li class="leaf menu-mlid-5684"><a href="/topics/tissue-viability" title="Tissue Viability">Tissue Viability</a></li> <li class="leaf menu-mlid-5671"><a href="/topics/cardiovascular-health" title="Cardiovascular Health">Cardiovascular Health</a></li> <li class="leaf menu-mlid-5675"><a href="/topics/diabetes" title="Endocrinology">Endocrinology</a></li> <li class="leaf menu-mlid-5676"><a href="/topics/falls-joints-bone-health" title="Falls and Balance">Falls and Balance</a></li> <li class="last leaf menu-mlid-5670"><a href="/topics/oncogeriatrics" title="Oncogeriatrics">Oncogeriatrics</a></li> </ul></li> <li class="leaf menu-mlid-9214"><a href="/topics/choosegeriatrics" title="#ChooseGeriatrics">#ChooseGeriatrics</a></li> <li class="leaf menu-mlid-9203"><a href="/topics/admission" title="Admission">Admission</a></li> <li class="leaf menu-mlid-9204"><a href="/topics/advance-care-planning" title="Advance Care Planning">Advance Care Planning</a></li> <li class="leaf menu-mlid-9205"><a href="/topics/alternative-therapy" title="Alternative therapy">Alternative therapy</a></li> <li class="leaf menu-mlid-9206"><a href="/topics/biology-of-ageing" title="Biology of Ageing">Biology of Ageing</a></li> <li class="leaf menu-mlid-9208"><a href="/topics/community-care" title="Community Care">Community Care</a></li> <li class="leaf menu-mlid-9209"><a href="/topics/continuing-professional-development-cpd" title="Continuing Professional Development (CPD)">Continuing Professional Development (CPD)</a></li> <li class="leaf menu-mlid-9210"><a href="/topics/disability" title="Disability">Disability</a></li> <li class="leaf menu-mlid-9211"><a href="/topics/discharge-planning" title="Discharge planning">Discharge planning</a></li> <li class="leaf menu-mlid-9212"><a href="/topics/dysphagiaswallowing" title="Dysphagia/Swallowing">Dysphagia/Swallowing</a></li> <li class="leaf menu-mlid-9213"><a href="/topics/exercise" title="Exercise">Exercise</a></li> <li class="last leaf menu-mlid-9202"><a href="/topics/hospital-at-home" title="Hospital at Home">Hospital at Home</a></li> </ul></li> <li class="leaf menu-mlid-7705"><a href="https://www.bgs.org.uk/resources" title="">Resources by date</a></li> <li class="leaf menu-mlid-9107"><a href="https://www.bgs.org.uk/resources?keywords=&group=All&type=All&field_resource_series_target_id_selective=All&tag=All&authors=All&from_date%5Bvalue%5D%5Bdate%5D=&to_date%5Bvalue%5D%5Bdate%5D=&sort_by=score" title="">Search resources</a></li> <li class="last leaf menu-mlid-3797"><a href="/AAAjournal">Age and Ageing journal</a></li> </ul></li> <li class="expanded menu-mlid-3577"><a href="/bgs-groups">BGS groups</a><ul class="menu"><li class="first leaf menu-mlid-3575"><a href="/about/national-regional-groups" title="">Nations & Regions</a></li> <li class="last leaf menu-mlid-8435"><a href="/bgs-groups/bgs-special-interest-groups">Professions & Special Interest</a></li> </ul></li> <li class="last expanded menu-mlid-3256"><a href="/about">About</a><ul class="menu"><li class="first leaf menu-mlid-5591"><a href="/about/become-a-member-of-the-bgs">Become a member</a></li> <li class="expanded menu-mlid-3796"><a href="/about/our-purpose">Who we are</a><ul class="menu"><li class="first expanded menu-mlid-3710"><a href="/about/our-purpose/bgs-trustees-and-officers">Our Board of Trustees</a><ul class="menu"><li class="first leaf menu-mlid-7680"><a href="/about/our-purpose/bgs-trustees-and-officers/bgs-elections">BGS Elections</a></li> <li class="leaf menu-mlid-8767"><a href="/agm" title="">AGM</a></li> <li class="last leaf menu-mlid-9160"><a href="/about/our-purpose/bgs-trustees-and-officers/past-presidents">Past Presidents</a></li> </ul></li> <li class="leaf menu-mlid-7754"><a href="/about/our-purpose/bgs-staff">Our Staff Team</a></li> <li class="leaf menu-mlid-8768"><a href="/strategy">Our Strategy</a></li> <li class="last leaf menu-mlid-6700"><a href="/about/our-purpose/library-and-archives">Our History</a></li> </ul></li> <li class="expanded menu-mlid-9104"><a href="https://www.bgs.org.uk/get-involved" title="">Get involved</a><ul class="menu"><li class="first leaf menu-mlid-9108"><a href="/https%3A/www.bgs.org.uk/get-involved/get-involved">How to get involved</a></li> <li class="last leaf menu-mlid-6967"><a href="/https%3A/www.bgs.org.uk/get-involved/our-partner-organisations">Our partner organisations</a></li> </ul></li> <li class="expanded menu-mlid-6698"><a href="/bgsvacancies">Vacancies</a><ul class="menu"><li class="first collapsed menu-mlid-8438"><a href="/bgsvacancies" title="">BGS vacancies</a></li> <li class="leaf menu-mlid-7718"><a href="/about/external-vacancies" title="">External vacancies</a></li> <li class="last leaf menu-mlid-8437"><a href="https://www.bgs.org.uk/submit-job-advert" title="">Submit a job vacancy</a></li> </ul></li> <li class="leaf menu-mlid-9096"><a href="/about/make-a-donation">Donate</a></li> <li class="last leaf menu-mlid-3711"><a href="/about/contact">Contact us</a></li> </ul></li> </ul></div> </section> <section class="block block-block search-toggle-wrapper"> <div class="search-toggle">Search</div> </section> <section class="block block-search"> <form action="/resources/reablement-rehabilitation-recovery-chapter-four-building-our-capacity-and-capability" method="post" id="search-block-form" accept-charset="UTF-8"><div><div class="container-inline"> <h2>Search</h2> <div class="form-wrapper"> <div class="form-item form-type-textfield form-item-search-block-form"> <label class="element-invisible" for="edit-search-block-form--2">Search </label> <input title="Enter the terms you wish to search for." type="text" id="edit-search-block-form--2" name="search_block_form" value="" size="15" maxlength="128" class="form-text" /> </div> <div class="form-actions form-wrapper" id="edit-actions"><input type="submit" id="edit-submit" name="op" value="Search" class="form-submit" /></div><input type="hidden" name="form_build_id" value="form-FvX1Gn5Z11tIYvmem17ZRveVvL7FtTm1knt1GwqdRbc" /> <input type="hidden" name="form_id" value="search_block_form" /> </div> </div> </div></form> </section> </nav> </div> </div> </header> <section id="breadcrumb"> <div class="outer-wrapper"> <div class="breadcrumb"><span class="first"><a href="/">Home</a></span><span class="crumb-1"><a href="/resources">Resources</a></span><span class="last">Resources</span></div> </div> </section> <div class="tabs outer-wrapper"> </div> <main role="main"> <div class="outer-wrapper"> <aside id="sidebar-first" role="complementary" class="sidebar"> <div id="block-block-1" class="block block-block soc-accelerators"> <div class="soc-accelerators-inner"><div class="block-content-wrapper clearfix"> <h2>Share</h2> <div class="content"> <div class="card-links"> <ul> <li class="facebook"><a title="Share on Facebook." href="http://www.facebook.com/sharer.php?u=https://www.bgs.org.uk/resources/reablement-rehabilitation-recovery-chapter-four-building-our-capacity-and-capability&t=Reablement%2C+Rehabilitation%2C+Recovery%3A+Chapter+four+-+Building+our+capacity+and+capability" rel="nofollow" target="_blank">Share on Facebook</a></li> <li class="twitter"><a target="_blank" rel="nofollow" title="Share this on Twitter" href="http://twitter.com/share?url=https://www.bgs.org.uk/resources/reablement-rehabilitation-recovery-chapter-four-building-our-capacity-and-capability&text=Reablement%2C+Rehabilitation%2C+Recovery%3A+Chapter+four+-+Building+our+capacity+and+capability">Tweet</a></li> <li class="linkedin"><a title="Share on LinkedIn" href="http://www.linkedin.com/shareArticle?mini=true&url=https://www.bgs.org.uk/resources/reablement-rehabilitation-recovery-chapter-four-building-our-capacity-and-capability&title=Reablement%2C+Rehabilitation%2C+Recovery%3A+Chapter+four+-+Building+our+capacity+and+capability]&source=ALNAP" rel="nofollow" target="_blank">Share on LinkedIn</a></li> <li class="email"><a title="Share by Email" href="mailto:?subject=I wanted you to see this site&body=Check out this site https://www.bgs.org.uk/resources/reablement-rehabilitation-recovery-chapter-four-building-our-capacity-and-capability" rel="nofollow">Share by Email</a></li> <li class="calendar"> </li> </ul> </div> </div> </div></div> </div> </aside> <section id="content"> <div class="content-main"> <article id="node-7475" class="node node-resource node-content" about="/resources/reablement-rehabilitation-recovery-chapter-four-building-our-capacity-and-capability" typeof="sioc:Item foaf:Document"> <div class="resource-header node-header"> <h1><div class="card-full-title"> Reablement, Rehabilitation, Recovery: Chapter four - Building our capacity and capability </div> </h1> <span property="dc:title" content="Reablement, Rehabilitation, Recovery: Chapter four - Building our capacity and capability" class="rdf-meta element-hidden"></span><span property="sioc:num_replies" content="0" datatype="xsd:integer" class="rdf-meta element-hidden"></span> <div class="resource-header-details"> <div class="card-resource-type-i"> <div class="card-resource-type"> Report </div> <div class="resource-type-i-icon">i</div> <div class="resource-type-info-arrow"></div> </div> <div class="resource-type-info"><div class="resource-type-info-text"></div></div> </div> <div class="node-header-details"> <div class="card-authors-wrapper"><div class="label">Authors:</div><div class="author-details">British Geriatrics Society</div><div class="author-details">Professor Anne Hendry</div><div class="author-details">Rehabilitation working group</div></div> <div class="card-topics-wrapper"><div class="label">Topics:</div><a href="/taxonomy/term/790">Deconditioning</a>, <a href="/taxonomy/term/3176">Rehabilitation</a></div> <div class="node-header-dates"> <div class="card-date-wrapper"><div class="label">Date Published:</div><div class="card-date"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2024-05-15T00:00:00+01:00">15 May 2024</span> </div> </div> <div class="card-date-updated"> <div class="label">Last updated: </div> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2024-05-15T16:33:00+01:00">15 May 2024</span> </div> </div> </div> <div class="card-resource-summary"> <p>This chapter looks at the workforce, training and physical space requirements for the delivery of rehabilitation, and considers some solutions to existing barriers.</p> </div> </div> <div class="view view-sections view-id-sections view-display-id-main view-dom-id-6e9bea8d20de22f8a79a67ef670c4a40"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first section-row palette-default img-left "> <div class="section-inner"> <div class="card-original"> <picture >  <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-wide/public/content/paragraphs/text/images/2024-05-15/6_0.png?itok=ZXF29uqn&timestamp=1715769838 1x" media="(min-width: 75em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-normal/public/content/paragraphs/text/images/2024-05-15/6_0.png?itok=-5y4KXoN&timestamp=1715769838 1x" media="(min-width: 60em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-narrow/public/content/paragraphs/text/images/2024-05-15/6_0.png?itok=kxNjdIKD&timestamp=1715769838 1x" media="(min-width: 45em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-mobile/public/content/paragraphs/text/images/2024-05-15/6_0.png?itok=uFWPFJjV&timestamp=1715769838 1x" media="(min-width: 0em)" />  <img src="https://www.bgs.org.uk/sites/default/files/styles/nugget-mobile/public/content/paragraphs/text/images/2024-05-15/6_0.png?itok=uFWPFJjV&timestamp=1715769838" alt="" title="" /> </picture> </div> <div class="card-body"> <h2 class="sidebar-nav">Proactive and integrated workforce model </h2> <p class="larger-text">Many staff from different healthcare disciplines, social care and housing providers, community and third sector partners work alongside unpaid carers to support older people to achieve their rehabilitation goals.</p> <p>Family carers provide valuable support for recovery and need to be supported as equal partners in care, albeit recognising their capacity may be limited due to their own health or other constraints. Which practitioners should be involved in rehabilitation should be based on holistic assessment of need and individualised goals. Multidisciplinary teams are varied in composition and the leadership of the team should not be based on an idea of ‘seniority’ but on which team member has expertise in the priority concern of the individual. </p> <p>Integrated workforce planning is required to meet the growing demand for rehabilitation in an ageing population. NHS England suggests education and training places for allied health professions will need to grow by as much as 25% by 2030-31 to meet demand.<sup>84 </sup></p> <p>Workforce models that optimise skill mix and enable people to work at the top of their licence can increase system capacity and extend the reach to older people who are currently excluded from access to rehabilitation. A strategic and integrated approach can be facilitated by appointing a rehabilitation director operating at executive level within the system and establishing a local network of providers who consider existing services and collaborate to improve access, ensure equity of provision, reduce fragmentation and make best use of collective workforce capacity. Capacity planning involves assessing needs of individuals and aggregating at a neighbourhood level. There are models to help in planning required capacity.<sup>85</sup> Population segmentation and risk stratification have been applied over recent decades to better understand levels of need within a neighbourhood and plan capacity of teams accordingly.</p> <p>Many rehabilitation programmes are for specific conditions (eg stroke, heart failure, respiratory disease) but often have common elements and shared resources that are useful for people with multimorbidity or frailty. Flexible delivery may enhance interdisciplinary learning and service efficiency as illustrated by the generic Healthy and Active Rehabilitation Programme developed in Ayrshire in Scotland, working with leisure service partners.<sup>86</sup> </p> <p>The Collaborate Don’t Compete project<sup>87</sup> describes how different exercise professionals can work together to promote stronger rehabilitation outcomes, including for older people. </p> <table> <tbody> <tr> <td><strong>Key message 8</strong><br /> Rehabilitation is a multi-agency endeavour involving many health and social care disciplines, voluntary sector, volunteers, unpaid carers, housing and community leisure services. Systems should work with all partners to offer rehabilitation for older people as a key component of health and social care within age-friendly communities.</td> </tr> </tbody> </table> </div> <div class="card-view-4"> <div class="view view-attachment view-id-attachment view-display-id-main view-dom-id-853f80bd32a81426a6349ca1e3c20967"> </div> </div> </div> </div> <div class="views-row views-row-2 views-row-even section-row palette-default "> <div class="section-inner"> <div class="card-title"> <h2 class="field-content">Case study examples</h2> </div> <div class="card-view-4"> <div class="view view-attachment view-id-attachment view-display-id-main view-dom-id-7a40f5e7cb909ec2bab6d44165ee2fe7"> </div> </div> <div class="card-view-3"> <div class="view view-faqs view-id-faqs view-display-id-qa_main view-dom-id-7295ebfc5cf3a86632cc49d6e07c71aa"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first views-row-last"> <div class="faq-question"> <div class="card-qa-question"> NHS Fife Intermediate Care Service </div> <div class="card-qa-answer"> <p>The NHS Fife Intermediate Care Service provides rehabilitation to people within their own homes. This community rehabilitation initiative aims to ensure patients have the best chance of achieving their personal goals, improving independence, general health and wellbeing, whilst in their home or homely setting. </p> <p>Working together to improve outcomes for Pat in St Andrews, Fife:  Following initial inpatient rehabilitation after a stroke, Pat was referred to the local intermediate care team for Early Supported Discharge rehabilitation at home with a personal goal to be able to walk outside again with a stick. Rehabilitation support workers visited Pat daily, encouraging her to regain independence with personal care, and developed a personalised exercise programme to promote balance, mobility, self-management, independence and wellbeing. Pat progressed to walk with a stick indoors then outside with support workers. She started an out-patient rehabilitation class at the local community hospital and was motivated by exercising with others. She then moved on to Active Options, a community exercise group. A local area co-ordinator helped Pat identify a social group that could support her to get out and about, be active and socialise.</p> <p>Read more about community rehabilitation in NHS Fife at <a href="http://www.nhsfife.org/services/all-services/icass-integrated-community-assessment-and-support-services/intermediate-care-service/community-rehabilitation">www.nhsfife.org/services/all-services/icass-integrated-community-assessm...</a></p> </div> </div> </div> </div> </div> </div> </div> </div> <div class="views-row views-row-3 views-row-odd section-row palette-default img-right "> <div class="section-inner"> <div class="card-original"> <picture >  <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-wide/public/content/paragraphs/text/images/2024-05-15/7.png?itok=DwTFYc28&timestamp=1715769777 1x" media="(min-width: 75em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-normal/public/content/paragraphs/text/images/2024-05-15/7.png?itok=F3wagOxt&timestamp=1715769777 1x" media="(min-width: 60em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-narrow/public/content/paragraphs/text/images/2024-05-15/7.png?itok=18AGjerG&timestamp=1715769777 1x" media="(min-width: 45em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-mobile/public/content/paragraphs/text/images/2024-05-15/7.png?itok=BL4I1JLR&timestamp=1715769777 1x" media="(min-width: 0em)" />  <img src="https://www.bgs.org.uk/sites/default/files/styles/nugget-mobile/public/content/paragraphs/text/images/2024-05-15/7.png?itok=BL4I1JLR&timestamp=1715769777" alt="" title="" /> </picture> </div> <div class="card-body"> <h2 class="sidebar-nav">Education and training support </h2> <p class="larger-text">Professionals engaged in rehabilitation need core competencies in communication, shared decision-making, goal-setting and collaborative practice. They also need skills in assets-based approaches, supporting self-management, identifying and escalating potential medication-related problems, and identifying and signposting carers to support for wellbeing.</p> <p>Education should include raising awareness of human rights duties such as challenging ageism and ageist stereotypes; confidence in tolerating risk in encouraging mobility; understanding how to create a safe and enabling physical environment; and support for motivational coaching and behaviour change to sustain the gains. Student placements, simulations and rotational posts that offer experience in different settings are valuable. Non-registered members of staff are critical in delivering programmes of rehabilitation and need training to equip them to have the right skills. </p> <p>The BGS offers an online educational module on frailty88 that can support practitioners contributing to rehabilitation to develop these important competencies. NHS England also offers a frailty e-learning module for the public and for generalist professionals that includes a sub-section on rehabilitation.89 Additional required rehabilitation competences include skills such as case management and care coordination as reflected in a new capability framework for virtual wards and hospital at home services in England.<sup>90</sup></p> <table> <tbody> <tr> <td><strong>Key message 9 </strong><br /> Rehabilitation is everyone’s business – older people themselves, carers and all health, social care, housing and voluntary sector workforce need to understand how to motivate and support enablement in later life. Systems should work with education providers to support everyone involved to work together and at the top of their licence to increase collective capacity for reablement and rehabilitation for older people.</td> </tr> </tbody> </table> </div> <div class="card-view-4"> <div class="view view-attachment view-id-attachment view-display-id-main view-dom-id-a0eafa031dd9ec0d8e147486ec46b9fa"> </div> </div> </div> </div> <div class="views-row views-row-4 views-row-even section-row palette-default "> <div class="section-inner"> <div class="card-title"> <h2 class="field-content">Case study examples</h2> </div> <div class="card-view-4"> <div class="view view-attachment view-id-attachment view-display-id-main view-dom-id-5bbe3cca2bee15523a612d4c40c2b3df"> </div> </div> <div class="card-view-3"> <div class="view view-faqs view-id-faqs view-display-id-qa_main view-dom-id-eb22362de4468594b6dc6ccedce6a274"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first"> <div class="faq-question"> <div class="card-qa-question"> Bevan Exemplar project </div> <div class="card-qa-answer"> <p>A Bevan Exemplar project in a community hospital in Wales upskilled healthcare support workers as Rehab Champions to reduce delays between purposeful therapy contacts and to help the MDT adopt a 24-hour approach to implementing rehabilitation plans for patients. Patients were discharged with lower dependency, smaller packages of care than anticipated, reduced manual handling equipment needs and had a shorter length of stay than the previous average. </p> <p>Read the case study at <a href="https://bevancommission.org/wp-content/uploads/2023/08/Rebecca-McConell-BCUHB-.pdf ">https://bevancommission.org/wp-content/uploads/2023/08/Rebecca-McConell-...</a></p> </div> </div> </div> <div class="views-row views-row-2 views-row-even views-row-last"> <div class="faq-question"> <div class="card-qa-question"> Occupational therapists and physiotherapists in integrated community services at Guy’s and St. Thomas’ NHS Foundation Trust </div> <div class="card-qa-answer"> <p>Occupational therapists and physiotherapists in integrated community services at Guy’s and St. Thomas’ NHS Foundation Trust complete an enhanced Level 1 Medicines Reconciliation as part of the patient’s initial assessment. This facilitates timely identification of issues relating to medicines, and prompts consideration of the impact of medicines on rehabilitation goals (e.g. on pain management). Where required, therapists refer to a team of pharmacists and pharmacy technicians to support the optimisation of medicines. </p> <blockquote><p>“The occupational therapist checked the medication that I had been given by the Hospital and noticed missing medication and contacted my GP to arrange for it to be re-prescribed. They also supported me in contacting my GP, as I wanted a lower dose of pain killers (that I was not allergic to). My GP, encouraged by their email, acted quickly but I still did not have my newly prescribed medication, and the pharmacy were not answering when I tried several times to enquire by phone. The occupational therapist telephoned directly and got through and by that evening the newly prescribed medication had been delivered to my home.” <br /> - <em>Patient at Guy’s and St Thomas’ NHS Foundation Trust</em></p> </blockquote> </div> </div> </div> </div> </div> </div> </div> </div> <div class="views-row views-row-5 views-row-odd section-row palette-default "> <div class="section-inner"> <div class="card-body"> <h2 class="sidebar-nav">Physical environment</h2> <p class="larger-text">The optimal environment for rehabilitation is generally the individual’s home but this may not be feasible for some people due to lack of space, lack of equipment, or challenging circumstances, particularly for older people who live alone and need support to engage in rehabilitation. </p> <p>Provision of simple equipment can be crucial in ensuring that an individual is able to rehabilitate in their own home. In all settings, the physical environment should be able to support older people who require specific support for sensory, functional or cognitive impairments or to help them engage with the rehabilitation process. </p> <p>Physical space for rehabilitation in hospitals has diminished in recent years, exacerbated by the pandemic and by a spiralling maintenance backlog resulting in closure of some areas for extended periods of time. In some hospitals, the function of former rehabilitation spaces has changed to accommodate patients with acute medical needs. In a survey by CSP at the end of 2022, physiotherapists reported a loss of rehabilitation space in more than 100 areas across the UK. In a follow-up survey in May 2023, 96% of respondents said the situation had stayed the same or worsened. Rehabilitation needs the appropriate space, facilities and IT infrastructure. </p> <blockquote><p>On the Occupational Therapist’s first visit to my home, she noticed that my raised toilet seat was not fitted correctly as my toilet seat underneath was broken. It had caused a few scary moments when it kept slipping when using it. She immediately securely fitted the raised toilet seat, and it was wonderful to have a safe toilet to use. When she saw I was struggling to move my meals from the kitchen to my table, she arranged a trolley, which has been a real life saver as there were many things I could not carry due to being on two crutches. The trolley has helped improve my daily living considerably. She was excellent in helping me with Adult Social Services to get installed bathroom aids, a bed rail and grab rails at my front door. All have helped in my daily living needs and will continue to be of help, as I have a permanent issue with my right knee.” - <em>Patient at Guy’s and St Thomas’ NHS Foundation Trust</em></p> </blockquote> <table> <tbody> <tr> <td><strong>Key message 10</strong><br /> Rehabilitation needs the appropriate space, equipment, facilities and IT infrastructures, including access to care records that can be shared across providers in all care settings. Systems should commission a menu of options from a range of partners in environments that are fit for purpose. Services should be of sufficient duration to enable older people to achieve their social goals as well as undertake activities of daily living at home.</td> </tr> </tbody> </table> </div> <div class="card-view-4"> <div class="view view-attachment view-id-attachment view-display-id-main view-dom-id-ccb10df6dbc3e85a846eb6aefc3d87e6"> </div> </div> </div> </div> <div class="views-row views-row-6 views-row-even section-row palette-default img-left "> <div class="section-inner"> <div class="card-original"> <picture >  <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-wide/public/content/paragraphs/text/images/2024-05-15/4.png?itok=bu1Bbi0l&timestamp=1715769777 1x" media="(min-width: 75em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-normal/public/content/paragraphs/text/images/2024-05-15/4.png?itok=dqoDspNY&timestamp=1715769777 1x" media="(min-width: 60em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-narrow/public/content/paragraphs/text/images/2024-05-15/4.png?itok=SF8NpYev&timestamp=1715769777 1x" media="(min-width: 45em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-mobile/public/content/paragraphs/text/images/2024-05-15/4.png?itok=SBUZF89M&timestamp=1715769777 1x" media="(min-width: 0em)" />  <img src="https://www.bgs.org.uk/sites/default/files/styles/nugget-mobile/public/content/paragraphs/text/images/2024-05-15/4.png?itok=SBUZF89M&timestamp=1715769777" alt="" title="" /> </picture> </div> <div class="card-body"> <h2 class="sidebar-nav">Digital solutions </h2> <p class="larger-text">How patients receive their rehabilitation is important.</p> <p>In a study by the British Heart Foundation, while a majority of people expressed a preference for face-to-face support, others commented that they felt that they were able to get the same experience from a telephone or video call.<sup>91</sup> In a recent interview study within a trial of remote physiotherapy for early stage Parkinson’s disease, participants found remote consultation with a physiotherapist acceptable and liked the convenience of not having to travel to the clinic.<sup>92</sup> However technical difficulties included positioning of the camera and limitations of internet connectivity. If these challenges can be overcome, telerehabilitation has potential to make rehabilitation more accessible. Other considerations are lack of equipment, limited digital infrastructure, difficulty in establishing a therapeutic relationship online, a need for more training and support and simpler technologies that can be personalised.<sup>93</sup> </p> <p>An overview of technologies used to facilitate remote rehabilitation in adults with deconditioning, musculoskeletal conditions, stroke, or traumatic brain injury, was unable to draw firm conclusions.<sup>94 </sup>Targeted digital solutions for physical activity are more promising. A review of digitally enabled physical activity and exercise interventions for older residents in long-term care facilities reported increased function and activity.<sup>95</sup> A recent qualitative study which explored remote delivery of a programme of physical activity and exercise for people with early dementia or mild cognitive impairment during COVID-19 found that remote delivery could be challenging for carers, people with dementia and therapists.<sup>96</sup> However, creative approaches to address these issues were identified. </p> <p>Digital solutions are also required to enable continuity of information between providers and at transitions between settings or services. These are a key aspect of an integrated approach to rehabilitation. For example, a care plan should be able to be shared across interoperable systems and accessed and added to by key staff involved in rehabilitation and support. </p> <p>National IT solutions, such as the Summary Care Record application, may be useful but most areas have much work to do in information governance and interoperability of systems to improve access to data for the range of providers of rehabilitation and intermediate care. </p> <p>The National Institute for Health and Care Research has produced guidelines for the use of virtual home assessment tools.<sup>97</sup></p> </div> <div class="card-view-4"> <div class="view view-attachment view-id-attachment view-display-id-main view-dom-id-90d32cfa19cd336d3462c1be088ce2b1"> </div> </div> </div> </div> <div class="views-row views-row-7 views-row-odd views-row-last section-row palette-default img-right "> <div class="section-inner"> <div class="card-original"> <picture >  <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-wide/public/content/paragraphs/text/images/2024-05-15/11.png?itok=Ef-vtQA3&timestamp=1715769897 1x" media="(min-width: 75em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-normal/public/content/paragraphs/text/images/2024-05-15/11.png?itok=hb68KAkg&timestamp=1715769897 1x" media="(min-width: 60em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-narrow/public/content/paragraphs/text/images/2024-05-15/11.png?itok=DVts4Zqb&timestamp=1715769897 1x" media="(min-width: 45em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/nugget-mobile/public/content/paragraphs/text/images/2024-05-15/11.png?itok=ZHrQG4_f&timestamp=1715769897 1x" media="(min-width: 0em)" />  <img src="https://www.bgs.org.uk/sites/default/files/styles/nugget-mobile/public/content/paragraphs/text/images/2024-05-15/11.png?itok=ZHrQG4_f&timestamp=1715769897" alt="" title="" /> </picture> </div> <div class="card-body"> <h2 class="sidebar-nav">Measuring what matters </h2> <p class="larger-text">As health and care systems implement new models of rehabilitation, there is a need to understand and communicate the benefits for patients, carers, professionals, organisations and systems.</p> <p>Multi-dimensional interventions for older people often prove challenging to evaluate. Analysis of rehabilitation service data is critical for planning, commissioning and monitoring their performance. Good quality data is a prerequisite for continuous quality improvement and benchmarking of rehabilitation services. However, we lack standard national datasets and there is often limited interoperability between the local datasets that exist in different care settings. A recent report by the Community Rehabilitation Alliance offers recommendations for addressing these issues.<sup>98</sup> </p> <p>Thoughtful consideration of different professional values, cultures and approaches is required when introducing tools to measure quality and outcomes of multidisciplinary rehabilitation interventions.<sup>99</sup></p> <p>Monitoring and evaluation of complex rehabilitation interventions will require a range of mixed methods approaches, depending on the maturity of the service. Ideally there should be a continuous quality improvement approach using small-scale local data to drive improved practice and outcomes at point of care. Periodic reviews of activity, case-mix and patient and carer feedback will support assessment of reach, inclusion and experience. More detailed evaluations should consider interdependencies through contribution analysis and assess both cost-effectiveness and social value. </p> <p>Considering wider outcomes beyond health, longevity and Quality Adjusted Life Years (QALY) will enable commissioners to have a broader understanding of effectiveness and value from investment in new ways of working.<sup>100,101 </sup></p> <p>Examples of monitoring and evaluation tools:</p> <ul> <li>The Measure Yourself Concerns and Wellbeing Tool from Meaningful Measures has been adopted by the Gloucestershire complex care at home service.<sup>102 </sup></li> <li>The International Consortium on Healthcare Outcomes has developed numerous tools for patient-centred outcome measure.<sup>103</sup></li> <li>The Welsh Government have published a rehabilitation evaluation framework to assist Health Boards, local authorities and third sector partners to understand the demand for and to evaluate the impact of rehabilitation.<sup>104</sup></li> <li>Akpan and colleagues published a standard set of health outcome measures for older persons.<sup>105</sup></li> <li>A reablement team in Dumfries and Galloway, Scotland used the community IoRN2 tool (Indicator of Relative Need) to measure impact and as a catalyst for outcomes focused conversations and collaborative practice.<sup>106</sup></li> <li>The Patient-Reported Outcomes Measurement Information System (PROMIS) is a short form designed to measure physical function in geriatric rehabilitation patients.<sup>107</sup></li> <li>The BEPOP (Benchmarking Exercise Programme for Older People) national benchmarking first wave seeks to determine and promote exercises associated with positive outcomes for older people living with, or at risk of, sarcopenia or physical frailty.<sup>108 </sup></li> </ul> <table> <tbody> <tr> <td><strong>Key message 11</strong><br /> The quality of rehabilitation services should be monitored, tracking changes in health and functional outcomes, patient and carer experience, and considering coverage and cost-effectiveness. This intelligence should be used to continually improve services. Quality indicators should acknowledge personalised goals and outcomes, and that delay of further functional decline may be a more realistic outcome than recovery of independence for people who have progressive life-limiting illness or are at the end of life.</td> </tr> </tbody> </table> </div> <div class="card-view-4"> <div class="view view-attachment view-id-attachment view-display-id-main view-dom-id-7a81248c0b2893de83d603dae6a995ec"> </div> </div> </div> </div> </div> </div> </article> </div> <div class="content-additional"> <div id="block-webform-client-block-227" class="block block-webform"> <h2 class="resource-feedback-toggle">Feedback on this resource?</h2> <div class="content"> <div id="webform-ajax-wrapper-227"><form class="webform-client-form webform-client-form-227" action="/resources/reablement-rehabilitation-recovery-chapter-four-building-our-capacity-and-capability" method="post" id="webform-client-form-227" accept-charset="UTF-8"><div><div class="webform-email form-item webform-component webform-component-email webform-component--email webform-container-inline"> <label for="edit-submitted-email">Email </label> <input class="email form-text form-email" type="email" id="edit-submitted-email" name="submitted[email]" size="60" /> <div class="description">If you’d like us to contact you, please leave your email</div> </div> <div class="webform-feedback form-item webform-component webform-component-textarea webform-component--comment webform-container-inline"> <label for="edit-submitted-comment">Your feedback <span class="form-required" title="This field is required.">*</span></label> <div class="form-textarea-wrapper"><textarea required="required" placeholder="(max 300 words)" id="edit-submitted-comment" name="submitted[comment]" cols="60" rows="3" class="form-textarea required"></textarea></div> </div> <input type="hidden" name="details[sid]" /> <input type="hidden" name="details[page_num]" value="1" /> <input type="hidden" name="details[page_count]" value="1" /> <input type="hidden" name="details[finished]" value="0" /> <input type="hidden" name="form_build_id" value="form-Q-xCnfL7Z6Fpj19L8eEgjMImO5gcPNefTIsiB0EpDyg" /> <input type="hidden" name="form_id" value="webform_client_form_227" /> <input type="hidden" name="webform_ajax_wrapper_id" value="webform-ajax-wrapper-227" /> <fieldset class="captcha form-wrapper"><legend><span class="fieldset-legend">CAPTCHA</span></legend><div class="fieldset-wrapper"><div class="fieldset-description">This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.</div><input type="hidden" name="captcha_sid" value="8291826" /> <input type="hidden" name="captcha_token" value="c34e2910d9fdef5849d8d5c2e68f3175" /> <input type="hidden" name="captcha_response" value="Google no captcha" /> <div class="g-recaptcha" data-sitekey="6LdxcUsUAAAAABXmfqM-hujH0UGJIQjSzRbBKU2w" data-theme="light" data-type="image"></div></div></fieldset> <div class="form-actions"><input class="webform-submit button-primary form-submit" id="edit-webform-ajax-submit-227" type="submit" name="op" value="Send" /></div></div></form></div> </div> </div> </div> </section> <aside id="sidebar-second" role="complementary" class="sidebar"> <div class="sidebar-second-wrapper"> <section class="block block-views side-row resource-dl-block"> <h2 class="block-title">Download</h2> <div class="view view-resource-download view-id-resource_download view-display-id-download view-dom-id-acd5b2962f7a38b463f5dae8d91e572c"> <div class="view-content view-content-main"> <div> </div> </div> </div> </section> <section class="block block-views"> <div class="view view-sections view-id-sections view-display-id-sidebar view-dom-id-72ce0063cd5eb0b96477628cff3e0507"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first row-max-4 side-row "> <div class="section-inner"> <div class="card-title"> <h2 class="field-content">Back to report</h2> </div> <div class="side-row-wrapper"> <div class="card-view"> <div class="view view-links view-id-links view-display-id-block equal-heights view-dom-id-22cc1e70723b0df322be552ebbf99d8a"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first views-row-last"> <article id="node-7471" class="node node-resource-series" about="/Rehab" typeof="sioc:Item foaf:Document"> <a href="/Rehab" class="card"> <div class="card-image-wrapper"> <div class="card-image"> <picture >  <source srcset="https://www.bgs.org.uk/sites/default/files/styles/grid-6-wide/public/content/series/images/2024-05-14/Rehab%20websitecard%201.png?itok=o6IQdiNK&timestamp=1715702935 1x" media="(min-width: 75em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/grid-6-normal/public/content/series/images/2024-05-14/Rehab%20websitecard%201.png?itok=mFp05SBV&timestamp=1715702935 1x" media="(min-width: 60em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/grid-6-narrow/public/content/series/images/2024-05-14/Rehab%20websitecard%201.png?itok=6faMpycC&timestamp=1715702935 1x" media="(min-width: 45em)" /> <source srcset="https://www.bgs.org.uk/sites/default/files/styles/grid-6-mobile/public/content/series/images/2024-05-14/Rehab%20websitecard%201.png?itok=f7aM4hnJ&timestamp=1715702935 1x" media="(min-width: 0em)" />  <img src="https://www.bgs.org.uk/sites/default/files/styles/grid-6-mobile/public/content/series/images/2024-05-14/Rehab%20websitecard%201.png?itok=f7aM4hnJ&timestamp=1715702935" alt="" title="" /> </picture> </div> </div> <div class="card-text"> <h3><div class="card-title-field"> Reablement, Rehabilitation, Recovery: Everyone’s business </div> </h3> <div class="card-summary"><div class="card-summary-wrapper"> <p>This report sets out what high-quality rehabilitation for older people with frailty looks like, and how it should be delivered. </p> </div></div> </div> </a> </article> </div> </div> </div> </div> </div> </div> </div> <div class="views-row views-row-2 views-row-even views-row-last side-row "> <div class="section-inner"> <div class="card-title"> <h2 class="field-content">Download as PDF</h2> </div> <div class="side-row-wrapper"> <div class="card-view-4"> <div class="view view-attachment view-id-attachment view-display-id-sidebar view-dom-id-1d8702ce91c21de65520ba47117af998"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first views-row-last"> <a class="attachment-link" target="_blank" href="https://www.bgs.org.uk/sites/default/files/content/attachment/2024-05-15/BGS%20Reablement%20rehabilitation%20recovery%20-%20Everyones%20business_2.pdf"><div class="file-cover"><img typeof="foaf:Image" src="https://www.bgs.org.uk/sites/default/files/styles/file-cover/public/content/attachment/2024-05-15/covers/Rehab%20report%20cover.png?itok=TgxhX8mN" width="120" height="170" alt="" /></div> <div class="file-icon file-type-pdf"><div class="file-name">Reablement, Rehabilitation, Recovery: Everyone's business</div><div class="file-details"><div class="file-extension">pdf</div><div class="file-size">2.09 MB</div></div></div> </a> </div> </div> </div> </div> </div> </div> </div> </div> </div> </section> </div> </aside> </div> </main> <section class="postscript-first"> <div class="postscript_first"> <section class="block block-views postscript-section-row-block"> <h2 class="block-title">Other resources in this series</h2> <div class="view view-resource-series view-id-resource_series view-display-id-block section-row row-max-4 view-card-default-palette view-dom-id-6d47240cbdcf086d454235036bdf7f55"> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first"> <a class="card resource-card" href="/resources/reablement-rehabilitation-recovery-chapter-one-about-this-report"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>Reablement, Rehabilitation, Recovery: Chapter one - About this report</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2024-05-15T00:00:00+01:00">15 May 2024</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> This chapter introduces the report with a foreword, executive summary and a roundup of our key messages. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Report </div> </div></div></a> </div> <div class="views-row views-row-2 views-row-even"> <a class="card resource-card" href="/resources/reablement-rehabilitation-recovery-chapter-two-purpose-and-context"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>Reablement, Rehabilitation, Recovery: Chapter two - Purpose and context </h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2024-05-15T00:00:00+01:00">15 May 2024</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> This chapter provides an overview of rehabilitation as a beneficial intervention for many older people living with frailty, and the current situation across the four nations of the UK. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Report </div> </div></div></a> </div> <div class="views-row views-row-3 views-row-odd"> <a class="card resource-card" href="/resources/reablement-rehabilitation-recovery-chapter-three-evidence-and-examples-at-different-system"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>Reablement, Rehabilitation, Recovery: Chapter three - Evidence and examples at different system touchpoints</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2024-05-15T00:00:00+01:00">15 May 2024</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> This chapter links the themes in this report to the touchpoints described in the BGS Blueprint, Joining the dots. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Report </div> </div></div></a> </div> <div class="views-row views-row-4 views-row-even views-row-last"> <a class="card resource-card" href="/resources/reablement-rehabilitation-recovery-chapter-five-conclusions-and-references"><div class="card-text"><div class="card-content"> <div class="card-title"> <h3>Reablement, Rehabilitation, Recovery: Chapter five - Conclusions and references</h3> </div> <div class="card-date-display-override"> <span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2024-05-15T00:00:00+01:00">15 May 2024</span> </div> <div class="card-summary"> <div class="card-summary-wrapper"> <div class="card-summary"> This final chapter reinforces the potential of rehabilitation for older adults and reflects on the current challenges of implementation, with some take-home messages. </div> </div> </div> </div><div class="card-footer"> <div class="card-resource-series"> In a series </div> <div class="card-resource-type"> Report </div> </div></div></a> </div> </div> <div class="view-footer"> <div class="card-feed-link"><a href="/Rehab">See all resources in this series</a></div> </div> </div> </section> </div> </section> <footer id="site-footer" role="contentinfo"> <section class="footer-first"> <div class="outer-wrapper"> <section class="block block-views"> <div class="view view-footer-sections view-id-footer_sections view-display-id-orgs view-display-grid view-dom-id-3f05955061adc6434e4c6ceb696689d9"> <div class="view-header"> <script> if(jQuery('#Main.CRM_Contribute_Form_Contribution_Main').length > 0){ jQuery('#Main.CRM_Contribute_Form_Contribution_Main').on('submit',function(e){ setTimeout(function(){ e.preventDefault(); let firstInvalidElement = jQuery('label.crm-inline-error:visible:first'); if(firstInvalidElement){ let fid=firstInvalidElement.attr('for'); let originalDisplay = jQuery('#'+fid).css('display'); jQuery('#'+fid).css('display', 'block'); jQuery('#'+fid).focus(); jQuery('#'+fid).css('display', originalDisplay); } },100) }); } </script> </div> <div class="view-content view-content-main"> <div class="views-row views-row-1 views-row-odd views-row-first section-row palette-default "> <div class="card-title"> <h2 class="field-content">Contact us</h2> </div> <div class="card-body"> <h6>British Geriatrics Society</h6> <p>Marjory Warren House<br /> 31 St John’s Square<br /> London EC1M 4DN</p> <p><a class="arrow" href="/about/contact">Visit us</a></p> <p><strong>Tel:</strong> +44 (0)20 7608 1369</p> <p><a href="/about/contact">Email us</a></p> <p class="smaller-text">Charity No 268762<br /> Company No 1189776 (England and Wales)</p> </div> </div> <div class="views-row views-row-2 views-row-even section-row palette-default "> <div class="card-title"> <h2 class="field-content">Quick links</h2> </div> <div class="card-body"> <p><a href="/media-enquiries">Media enquiries</a></p> <p><a href="/AGENDA">AGENDA</a></p> <p><a href="/about/what-we-do/age-and-ageing"><em>Age and Ageing</em> Journal</a></p> <p><a href="/about/make-a-donation">Donate</a></p> <p><a href="/blog">Our blog</a></p> <p><a href="/about/what-we-do/research-opportunities-and-cpd">BGS Grants</a></p> <p><a href="/about/bgs-vacancies">Jobs/Vacancies</a></p> </div> </div> <div class="views-row views-row-3 views-row-odd section-row "> <div class="card-title"> <h2 class="field-content">Follow us</h2> </div> <div class="card-follow-us-on"> <div class="item-list"><ul><li class="first"><div class='card-links'><a href="https://facebook.com/BGS1947" rel="nofollow" target="_blank">Facebook</a> </div></li> <li><div class='card-links'><a href="https://twitter.com/GeriSoc" rel="nofollow" target="_blank">Twitter</a> </div></li> <li class="last"><div class='card-links'><a href="http://linkedin.com/company/british-geriatrics-society" rel="nofollow" target="_blank">LinkedIn</a> </div></li> </ul></div> </div> </div> <div class="views-row views-row-4 views-row-even views-row-last section-row palette-default "> <div class="card-title"> <h2 class="field-content">Sign up for our e-bulletin</h2> </div> <div class="card-body"> <a href="/user/register" class="button">Sign up</a> <style> .webform-container-inline.webform-datepicker div, .webform-container-inline.webform-datepicker input { display: inline-block !important; margin-top: 1em; } select { padding-right: 39px; background-size: 29px; } #multiple_block > input { display: inline-block; } </style> </div> </div> </div> </div> </section> </div> </section> <section class="footer-third"> <div class="outer-wrapper"> <section class="block block-menu"> <ul class="menu"><li class="first leaf"><a href="/terms-of-use">Website Terms of use</a></li> <li class="leaf"><a href="/privacy-statement">Privacy Statement</a></li> <li class="leaf"><a href="/membership-terms-and-conditions" title="ToC governing membership of the BGS">Membership Terms and Conditions</a></li> <li class="last leaf"><a href="/event-booking-terms-and-conditions" title="">Event Booking Terms and Conditions</a></li> </ul> </section> <div id="manta-ray-media">Built by <a href="http://www.mantaraymedia.co.uk/" target="_blank">Manta Ray Media</a></div> </div> </section> </footer> </div>  <div class="pswp" tabindex="-1" role="dialog" aria-hidden="true">  <div class="pswp__bg"></div>  <div class="pswp__scroll-wrap">  <div class="pswp__container"> <div class="pswp__item"></div> <div class="pswp__item"></div> <div class="pswp__item"></div> </div>  <div class="pswp__ui pswp__ui--hidden"> <div class="pswp__top-bar">  <div class="pswp__counter"></div> <button class="pswp__button pswp__button--close" title="Close (Esc)"></button> <button class="pswp__button pswp__button--share" title="Share"></button> <button class="pswp__button pswp__button--fs" title="Toggle fullscreen"></button> <button class="pswp__button pswp__button--zoom" title="Zoom in/out"></button>   <div class="pswp__preloader"> <div class="pswp__preloader__icn"> <div class="pswp__preloader__cut"> <div class="pswp__preloader__donut"></div> </div> </div> </div> </div> <div class="pswp__share-modal pswp__share-modal--hidden pswp__single-tap"> <div class="pswp__share-tooltip"></div> </div> <button class="pswp__button pswp__button--arrow--left" title="Previous (arrow left)"> </button> <button class="pswp__button pswp__button--arrow--right" title="Next (arrow right)"> </button> <div class="pswp__caption"> <div class="pswp__caption__center"></div> </div> </div> </div> </div> <script type="text/javascript" async="async" src="/sites/all/modules/picture/picturefill2/picturefill.min.js?v=2.3.1"></script> <script type="text/javascript" async="async" src="/sites/all/modules/picture/picture.min.js?v=7.74"></script> <script type="text/javascript" src="/sites/all/modules/photoswipe/js/photoswipe.jquery.js?sn052y"></script> <script type="text/javascript" src="/sites/all/modules/mautic-drupal/js/mauticform-prefill.js?sn052y"></script> </body> </html>