Journey in trying to achieve eligibility level 1 rehabilitation service

Abstract

Purpose -This article aims to cover the experience of working with the new framework/criteria for specialist neuro-rehabilitation services to meet the needs of patients with rare or complex conditions to achieve eligibility for a level 1 status.Design/methodology/approach -Royal Leamington Spa Rehabilitation Hospital is currently collecting the full UK Rehabilitation Outcomes Collaborative (UKROC) dataset for all in-patient episodes. A number of tools for measuring rehabilitation needs were gathered by the multi-disciplinary team (i.e. costing of the service including staffing, building, equipments, etc.), and a range of clinical measures including needs: (the rehabilitation complexity scale); inputs: the Northwick Park nursing and therapy dependency scales (NPDS, NPTDA); and outcomes: the UK functional assessment measure (UK FIM þ FAM) which are collated on the national UKROC database.Findings -These measures have been used to assess the level of a patient's complex needs and to help formulate bandings, which are being used to inform national tariffs. A number of advantages and disadvantages have been acknowledged from the introduction of the new criteria and have been addressed in this viewpoint. As the current trend for services is to be paid (payment by results) depending on activity and outcome, it is essential to provide good outcome data to monitor performance and justify the units' effectiveness.Originality/value -This paper outlines the authors' journey to achieve specialist commissioning and highlights the importance of monitoring and measuring the units' performance to reflect the continuous needs of the NHS and patients.