Clin Rehabil 2001 Dec;15(6):582-8
McMillan TM, Ledder H.
Department of Psychological Medicine,
University Glasgow, Gartnavel Royal Hospital, Glasgow, UK.
OBJECTIVE:
To survey the role, function and
staffing of community rehabilitation teams in London and the South East
NHS Region of England who work with neurologically disabled people, with
emphasis on services provided for traumatic brain injury.
DESIGN:
Telephone survey using a structured
interview with team leaders. Setting: London and South East NHS Regions
of England (population 15.6 million).
SUBJECTS:
Community rehabilitation teams.
MAIN OUTCOME MEASURES:
A structured interview about service
provision.
RESULTS:
Thirty-five teams were found in 25
Health Authorities serving 14 million people. In a further five Health
Authorities, another five teams did not participate. There were fewer than
1.5 community team professionals for 4,000-5,000 neurologically disabled.
Teams had seen less than 3% of disabled traumatic brain injuries. Most
focused on physical disability. Only two teams specialized in consequences
of cognitive impairment or personality change. Stroke and multiple sclerosis
were the most common referrals. Sixty per cent of teams had no clinical
psychologist. The composition of teams is described, as is caseload, clinical
role, outcome measures used, professional links, work practice and staffing
issues.
CONCLUSIONS:
Community physical disability teams
seem insufficiently resourced to provide a comprehensive service for the
neurologically disabled. There are not enough teams generally, and too
few specialize in psychosocial problems. All teams should include a clinical
psychologist, should have specialist resources for cases from ethnic minorities
and formal policies for staff security. There needs to be clarity over
the range of services provided and to whom, and this linked to prevalence
of disability and team resourcing.
PMID: 11777088 [PubMed - in process]