Level 1

 

The key criteria that identify a specialised Level 1 service

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• An inpatient service led by a consultant trained and accredited in Rehabilitation Medicine, and/or neuropsychiatry depending on caseload.

• Covers a population of >1 million patients, therefore requires collaborative commissioning.

• Caters for people whose needs are beyond the scope of their local specialist services and therefore has a high proportion of patients with very complex rehabilitation needs (category A patients, see below) who typically require longer lengths of stay than in local services.

• Is registered with the UKROC and contributes the full UKROC dataset for every patient enrolled for treatment within the rehabilitation programme under the specialist commissioning programme.

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Level 1 services are split into 3 distinct sub-categories:

• Level 1a - for patients with high physical dependency

• Level 1b - mixed dependency – physical and cognitive behavioural

• Level 1c - mainly ‘walking wounded’ patients with complex cognitive/behavioural challenges

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Level 2a

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The key criteria that identify a specialised Level 2a service

 

• An inpatient service led by a consultant trained and accredited in Rehabilitation Medicine, and/or neuropsychiatry depending on caseload.

• Covers an extended catchment population (600K- 1m).

• Has a mixed case load that includes a proportion of patients with very complex rehabilitation needs (category A patients) who typically require longer lengths of stay than in local services.

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Level 2b

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The key criteria that identify a specialised Level 2b service

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• An inpatient service led by a consultant trained and accredited in Rehabilitation Medicine, and/or neuropsychiatry depending on caseload.

• Has a local population as its caseload. This can include some patients with category A needs but is mostly for patients with Category B needs.

• Is funded by ICS and not NHS England.

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Level 3

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The key criteria that identify a specialised Level 3 service

 

• May be led by a consultant specialising in an area apart from rehabilitation (e.g. Care of the Elderly).

• Non-specialist rehabilitation teams providing general multi-professional rehabilitation and therapy support for a range of conditions - patients with category C or D needs.

• Serve a local population.

• Is funded by ICS and not NHS England.

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Patient Categorisation

Category A

Patients with Category A rehabilitation needs (requiring Level 1 specialised services) have complex or profound disabilities. For example, severe physical, cognitive communicative disabilities or challenging behaviors.

Category B

Patients with Category B rehabilitation needs have moderate to severe physical, cognitive and/or communicative disabilities which may include mild-moderate behavioural problems.

Category C

Patients with Category C rehabilitation needs have goals that are typically focused on restoration of function/independence and co-ordinated discharge planning with a view to continuing rehabilitation in the community. Patients require rehabilitation in the context of their specialist treatment as part of a specific diagnostic group, like stroke. Patients usually require less intensive rehabilitation intervention from 1-3 therapy disciplines in relatively short rehabilitation programmes.

Category D

Patients with Category D rehabilitation needs have a wide range of conditions but are usually medically stable. Patients require less intensive rehabilitation intervention from 1-3 therapy disciplines in relatively short rehabilitation programmes (i.e. up to 8 weeks)

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