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This strategy is an important step for cancer rehabilitation services as it directly links rehabilitation to survivorship. It adopts the recommendations of the National Cancer Survivorship Initiative, which state that people living with or beyond cancer should have access to physical activity interventions and vocational rehabilitation (section 5.17).
The strategy notes the improved experience of survivors and carers when rehabilitation services are available, and that additional funding is available from the government to the NHS for re-enablement where it will lead to reduced hospital readmissions (section 5.21). View Improving outcomes| [PDF, 1,007Kb].
The NHSOF is a set of outcome measures and indicators intended to hold the new NHS Commissioning Board to account on the performance of the NHS. Rehabilitation is only mentioned specifically in one indicator (3.6) in relation to older people who have been seriously ill or injured. However, in domain two (quality of life for people with long-term conditions) indicators reference the need for ‘physical activity’ (2.2) and ‘quality care’ (2.1 and 2.2), which could both encourage rehabilitation.View the Framework| [PDF, 237Kb].
With ongoing NHS reforms, it’s important to note how commissioning of rehabilitation services may be affected. Cancer networks will be retained in the new commissioning structure, but allied health professional rehabilitation leads will have to establish relationships with the new Clinical Commissioning Groups (CCGs) to allow for effective rehabilitation commissioning. However, commissioning for people with rare and complex conditions is changing significantly. The existing 10 Specialised Commissioning Groups will be replaced by CCGs, the NHS Commissioning Board, and local branches of the board.
The 2010–2011 National Cancer Peer Review highlighted some worrying trends for cancer rehabilitation funding, with concerns over the lack of investment in allied health professional rehabilitation leads at cancer networks. However, Health Secretary Andrew Lansley has announced a further £162 million investment in rehabilitation and re-enablement services| on top of the previously announced £70 million for 2011. Lansley has pledged that funding for rehabilitation services will reach £300 million by 2014–2015.
The coalition government has stated its commitment to integrated care, which could provide opportunities for rehabilitation services. Health and Wellbeing Boards will play a significant part in the new NHS structure linking public health and social care, and it is hoped they will play a role in rehabilitation commissioning. Care plans have also been emphasised as a key aspect of integrated cancer care and a way to highlight the rehabilitation needs of patients.
These standards were adopted in Wales in April 2010. All patients in Wales should now have a key worker to coordinate individual care (including rehabilitation), while other standards are required to be implemented by 2015. A rehabilitation advisory group has been coordinating all rehabilitation developments in the South Wales Cancer Network since April 2011, including implementation of the standards.
This document was published by the Welsh Government as the new delivery plan for cancer treatment to 2016. It includes a requirement to plan, review and reorganise rehabilitation services for people with cancer in line with the latest evidence; national standards and guidance; reports; and recommendations.View Together against cancer |[PDF, 738Kb].
The Scottish Government’s action plan for cancer services. It sets out details of a working group looking at how NHS Scotland can better support people living with and beyond cancer.You can view the report on the Scottish Government's website|.
In July 2010, the Department of Health, Social Services and Public Safety endorsed NICE Clinical Guideline No. 83, Rehabilitation After Critical Illness| [PDF, 496Kb]. The guidance sets out: the care pathway for people needing rehabilitation; screening and assessment tools; rehabilitation strategies; and other recommendations. The guidelines cover ‘adults, who as a result of critical illness, have stayed in critical care’ and therefore need rehabilitation. However, it does not cover people in the final stages of a terminal illness or adults whose rehabilitation is already routinely assessed.
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