As a result of the Covid-19 pandemic, NHS rehabilitation services have become increasingly stretched. Funding for vital rehabilitative care is essential to support major trauma survivors and those currently battling long-covid, as well as helping to prepare the NHS for any future surges in Covid-19 infections. This year’s Spring Budget was an opportunity to bridge the funding gap and provide vital resources for rehabilitative care, yet despite the clear need for additional resource in this area, it was unfortunately lacking. Unless addressed, this could have long lasting detrimental consequences for patient outcomes across the country.
Major trauma survivors and individuals with long-covid will all need access to fully funded and staffed rehabilitation services as we move out of the pandemic. Rehabilitation is not only vital for dealing with the immediate physical effects of injury, but also the psychological trauma that can be associated with major trauma accidents or severe illness. For many of these people, rehabilitation will be a long-term, if not life-long, necessity. In order to provide this essential care, rehabilitation services must be a priority for decision makers moving forward. This will also help to alleviate pressures on the NHS if services are becoming overwhelmed in future and the demand for rehab increases.
It is likely that producing this funding will need to be a collaborative effort involving different groups, such as the Government, charities, and private sector organisations. As it stands, funding from the Government and the third sector can only get us so far, and it is important for the private sector to step in where possible. One group in particular with the capabilities to do this is the UK insurance sector. This is a £35 billion industry that, in the face of the national crisis we find ourselves in, could begin to absorb a higher proportion of the costs of major trauma treatment than it has done to date. Considering this, and the fact that many insurers have made healthy profits during the pandemic, it would be a welcome approach if the insurance industry could voluntarily enhance funding for private rehabilitation.
Another way of freeing up funds for rehabilitation services is through reform to the Injury Cost Recovery (ICR) system for those in need of major trauma treatment. The ICR system was set up to enable NHS bodies to recover some of the cost of treatment for individuals who had suffered injuries where another party was required to pay compensation. One pressing problem with the ICR system in its current form is that the funding has not kept up with the growing costs of medical care. In fact, even before the start of the COVID-19 pandemic, NHS major trauma centres were having to spend over £16,000 per week per in-patient despite the compensation fees to the NHS from insurers being capped at £5,831 per week per in-patient. In addition, the current ICR system does not allow the NHS to claim for both in-patient and out-patient care, which if reformed could offer services a significant financial boost.
The need for rehabilitation is likely to increase as we move further out of the pandemic and back to our normal day-to-day lives, and the cost of this increase risks further stretching our already overburdened NHS. Funding for appropriate rehabilitation must become a priority for policymakers, charities, and private organisations alike, whether this comes through voluntary action or legislative change.