An image of a medical professional working a tablet containing a patient's medical information illustrating virtual care as the future of major trauma rehabilitation


Virtual care in Covid-19 – the future of major trauma rehabilitation?

Would a digital first approach to major trauma rehabilitation mean virtual care that could benefit many left behind during the pandemic? Michael Wangermann explores the future of major trauma rehabilitation.

In March 2020, at the start of the Covid-19 pandemic, Matt Hancock announced that the NHS would adopt a digital first approach to providing primary care and outpatient support. While many favour the new ease with which they can get medical advice without the need to wait for in person appointments, this also poses challenges for those with more complicated health care needs. Before committing to remote rehabilitation for major trauma survivors, we need to consider the success of virtual care and the impact this could have on long-term recovery.

Virtual care, the remote interaction between a medical practitioner and patient using any form of communication technology, was crucial in allowing patients to continue receiving care while in lockdown. In the first month of lockdown alone, the number of consultations carried out online rose from 2 percent to 80 percent. While this provided an excellent way to navigate the pandemic and healthcare provision, it seems that virtual care will be a feature of the NHS for the foreseeable future, despite the vaccine roll-out and the end of restrictions.

Virtual services were rolled out across a wide range of specialisms, with the specialist physiotherapy team at Central Cheshire Integrated Care Partnership treating over 3,000 patients with musculoskeletal issues remotely in just three months. Musculoskeletal injury refers to damage of muscular or skeletal systems, which is usually due to a strenuous activity, and this was hugely beneficial to ensure those in rehabilitation could continue their treatment via platforms such as Zoom. Furthermore, the Neurorehabilitation Online Project has also brought virtual neurorehabilitation to patients in need of ongoing care. This UCL and National Hospital for Neurology and Neurosurgery pilot scheme was established as a response to the pandemic in April 2020, funded by the charity SameYou.

These developments were an exciting step forward for major trauma patients and the possibility of expanded care provision in the future. If virtual care does become the norm, it would be reassuring for major trauma musculoskeletal outpatients to have a similar central hub for consultations, resources and communication. If there is to be a long-term change to the way parts of the NHS are delivered, we will need to see proper investment and funding into the platforms that provide virtual care.

Worries surrounding technological security and data protection are common, not to mention the lack of human interaction which is a vital component to treatment for many people. We must also consider socioeconomic and technical barriers to accessing virtual care that will need to be dealt with. Virtual care can connect those in rural areas and those who struggle with mobility, but only if they have the technological means and knowledge to participate. Therefore, a long-term commitment to virtual care needs to include investment and education.

It seems the future could very well entail a hybrid system of rehabilitation to ensure that the most vulnerable major trauma survivors are still treated in person and there is a priority system in place that can send those needing immediate attention to a medical facility. Virtual care can help to alleviate the strain on the NHS and broaden the reach of vital services. However, virtual rehabilitation can only begin to be a success if those who need it can access it. Major trauma rehabilitation is often complex and long-term in nature, so face-to-face appointments must remain as an option while further funding and resources are invested in virtual care.

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