R EHABI L I TATION
scaled back. The result of this will be longer waiting times for diagnoses and treatments, and an increase of the backlog that the pandemic caused in 2020. This could mean reducing current waiting times could take years.2 Any further increase of waiting times will be extremely problematic, especially for cancer patients. For example, it has been reported that the total number of patients waiting for cancer treatment on the 62-day pathway in England has increased from around 90,000 in mid-May to around 160,000 at the start of December 2020.3 Arguably, the most underreported victims of the COVID-19 pandemic are people that have sustained major trauma injuries. Due to the NHS backlog, this group of individuals will have been left waiting for vital rehabilitation, such as physiotherapy, hydrotherapy, or psychological therapy. This is a cause for concern as these therapies would have made a substantial difference to the success of survivors’ recoveries and, ultimately, to the quality of their day-to-day lives in the future.
The scale of the task now faced by the NHS cannot be underestimated, nor can the impact upon the hidden victims of COVID-19, and it is time to act to support the survivors of major trauma. In this regard, increased access to private rehabilitation for people that have sustained major trauma in appropriate circumstances would serve to relieve some of the pressure on the NHS. The need for increased access to and funding for rehabilitation services has never been more important and is highlighted by a recent study published in The Lancet examining the global need for rehabilitation services. The study found that globally, in 2019, 2.41 billion individuals had conditions that would benefit from rehabilitation. This number had increased by 63% from 1990 to 2019. The study’s authors suggest that at least one in every three people in the world needs rehabilitation at some point in the course of their illness or injury. The authors emphasise that this number counters the common view of rehabilitation as a service required by only a few people. They also argue that rehabilitation needs to be positioned as an integral part of primary healthcare in communities to reach more people in need.4 Access to rehabilitation services was
important before the pandemic for people suffering from conventional major trauma injuries, and this has only become more imperative over the last year. COVID-19 has brought with it the onset of so called ‘long COVID’, a condition whereby an individual that has contracted COVID-19 has persistent symptoms that linger long after they initially contracted the virus, and we are now seeing an increase in the number of people requiring rehabilitative care.
APRIL 2021
For example, a recent study by researchers from Patient-Led Research for COVID-19 revealed that nearly half of people with long COVID have been unable to properly return to work six months after infection. While some patients appear to recover from COVID-19, there are others who are left with debilitating fatigue and ‘brain fog’, which involves memory problems and an inability to focus.
Some 45% of people with long COVID
had a “reduced” work schedule compared to before their illness, a survey of more than 3,700 long COVID patients showed. It also showed that 22.3% were not working due to their health conditions. In addition, those who reported symptoms six months after infection said relapses were often triggered by exercise, physical or mental activity, and stress. The worsening of symptoms could follow even minor physical or mental exertion. Worst of all, an overwhelming majority (96%) said their symptoms lasted more than 90 days.5 In addition to long COVID, another concern is that road accidents and bicycle accidents will still have occurred throughout 2020, despite a decrease in driving during the various lockdowns. For example, for the year ending June 2020, there were 24,470 people killed or seriously injured in road traffic accidents reported to the police.6 Road accidents, due to speeding, drink driving or just carelessness, have huge impacts on the lives of victims as they often lead to lifelong physical and mental injuries. Some of the common physical and mental injuries that arise from road accidents include, among others, problems doing day-to-day physical activities, post-traumatic stress disorder, anxiety, and depression. Victims of road accidents require access to rehabilitation services to recover from such problems. The onset of long COVID and the persistence of road accidents is very worrying given the increase in COVID-19
infections at the start of this year and because rehabilitation services are already stretched.
As we continue to navigate our way through the pandemic, we could have a situation whereby people needing access to rehabilitation services, be that to treat long COVID or conventional major trauma injuries, cannot access the support they need because demand is significantly outstripping supply. There is, therefore, an urgent necessity for the healthcare sector and policymakers to work together to avoid this scenario at all costs.
Given the current financial pressures and burden that the NHS faces, we must be proactive in thinking about ways to help alleviate these issues, which range from long waiting times to the stress and anxiety of NHS staff. In this regard, it would be a welcome approach if the insurance industry could make a positive contribution to supporting the NHS at this difficult time by voluntarily funding private rehabilitation for people who have sustained major trauma. The UK insurance sector is a £35 billion industry and is more than capable of absorbing a higher proportion of the costs of major trauma treatment than it has done to date. This additional cost should be ring-fenced for rehabilitation services to ease pressure on the NHS. Indeed, it has been estimated that motor insurers have saved more than £4 billion as a consequence of the COVID-19 pandemic.7
As well as saving money, some insurers have made healthy profits. There is therefore no doubt that the motor insurance industry could make a significant contribution in support of our NHS and show the nation that we really are all in this together. Another easy way of freeing up funds for rehabilitation services is through reform to the Injury Cost Recovery system for those in need of major trauma treatment. The Injury Cost Recovery (ICR) system was set up to enable NHS bodies to recover some of the
WWW.CLINICALSERVICESJOURNAL.COM l 47
▲
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88
