Improving access to rehabilitation services key to reducing health inequalities, says new report

Millions of people are missing out on rehabilitation services, which is driving the increasing number of people living with multi-morbidity and is contributing towards the gap in healthy life expectancy, according to a new report.

The report, Rehabilitation, recovery and reducing health inequity: Easing the pain, says that rehabilitation can help to prevent further long-term conditions (LTCs) from developing and reduce the risk of deterioration, but millions are struggling to access these vital services.

The Chartered Society of Physiotherapy (CSP), who published the report, are therefore calling for better use of the “exemplary services” that already exist, and the creation of further services that are rooted in communities, particularly those in poorer areas, where higher numbers of people live with multi-morbidity.

People in poorest communities at increased risk of developing a long-term condition

The report found that there is a higher number of people with LTCs or multi-morbidity in deprived areas and in populations facing systemic discrimination and marginalisation.

In fact, people in the poorest communities have a 60% higher chance of being diagnosed with a LTC than those in the richest. They also have a 30% higher chance that their condition will be more severe.

Even after accounting for deprivation, prevalence of LTCs is higher amongst people aged 60+ who are from a black or minority ethnic group.

The CSP say that while poor access to NHS rehabilitation services is almost ubiquitous, people living in areas of high deprivation face more barriers to rehabilitation than wealthier areas, correlating to health inequity.

A new vision to transform rehabilitation

The Society are therefore calling for a “new vision to transform rehabilitation”. This includes building on the services that are already in existence, co-producing services with the public that are rooted in communities, and using data to drive improvements.

The CSP have worked with national charities and professional bodies to agree on principles for quality rehabilitation, that is “preventative, personalised, empowers self-management, works in partnership with patients and carers, based on need not diagnosis, incorporating psychological support, with more provision outside hospitals and making use of existing community assets.”

The recommendations include:

• The Department of Health and Social Care should commit funding to improve access to quality rehabilitation through implementation of the NHS Long Term Plan
• NHS England should work to deliver the rehabilitation elements of the refreshed NHS Long Term Plan to address health inequity and prioritise currently under-served groups
• Integrated Care Board should commit to reducing the gap in healthy life expectancy by developing their community rehabilitation offer and ensure rehabilitation is part of data improvement plans
• Place Boards should adopt outcome measures for access to community rehabilitation and support local partnerships between the local NHS providers, local authorities and fitness industry
• Rehabilitation/AHP leads should use e Community Rehabilitation Best Practice Standards and audit tools and work with PCNs to integrate provision at neighbourhood level.

Transforming the NHS from an ‘illness service to a health service’

The CSP also urge the UK government to follow through on the commitments it has made to addressing inadequate rehabilitation and disparities in healthy life expectancy, which are dependent on each other.

As the report states: “Building back and modernising our rehabilitation capacity as an equal pillar of healthcare is key to how we transform the NHS from being an illness service to a health service that can meet modern population needs sustainably and equitably.”