The document discusses the PAS 150 standards for rehabilitation services and factors that can affect the delivery of specialist rehabilitation services in the UK. It outlines three levels of rehabilitation services (local general, district specialist, and complex specialized) and describes the types of conditions and needs addressed at each level. It also identifies challenges in areas like commissioning, bed availability, discharge pathways, access to tertiary services, and consultant and staff shortages that can impact specialist rehabilitation services. The PAS 150 is presented as a tool to set standards and drive quality improvement across rehabilitation services.

1. PAS 150: The clinical viewpoint Diane Playford VRSIG Chair, British Society of Rehabilitation Medicine

3. Other sources of standards

10. Complex Specialised Rehabilitation (CSR) - Tertiary services (Level 1) District Specialist Rehabilitation (DSR) (Level 2) Local General Rehabilitation (LGR) (Level 3) Different levels of service Complexity of need Pts needing rehabilitation Av. cost

19. 5 year Cohort data: 297 consecutive admissions Turner-Stokes et al JNNP 2006; 77: 634-639 Dependency on admission High (NPDS > 25) Medium (NPDS >10-24) Low (NPDS <10) Initial cost of rehabilitation Mean LOS £41,782 155 days £27,774 104 days £17,226 71 days Mean weekly savings in care costs £673 per week £290 per week £83 per week Time to offset cost of rehabilitation 12 months 17 months 41 months

29. Factors affecting specialist rehabilitation services– shortage of consultants

32. Complex Specialised Rehabilitation (CSR) District Specialist Rehabilitation (DSR) Local General Rehabilitation (LGR) Banding for different levels of complexity in rehabilitation Complexity of need Areas covered by proposed HRGS Inputs FIM± FAM BI GAS Outcome