Recovery, rehabilitation and follow-up services following critical illness: an updated UK national cross-sectional survey and progress report.
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Authors
Milton-Cole, Rhian
Adams, Claire
Battle, Ceri
Quasim, Tara
Silversides, Jon
Slack, Andrew
Waldmann, Carl
Wilson, Elizabeth
Meyer, Joel
Faculty of Intensive Care Medicine Life After Critical Illness Working Group
Publication Date
2021-10-04Journal Title
BMJ Open
ISSN
2044-6055
Publisher
BMJ
Volume
11
Issue
10
Language
eng
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Connolly, B., Milton-Cole, R., Adams, C., Battle, C., McPeake, J., Quasim, T., Silversides, J., et al. (2021). Recovery, rehabilitation and follow-up services following critical illness: an updated UK national cross-sectional survey and progress report.. BMJ Open, 11 (10) https://doi.org/10.1136/bmjopen-2021-052214
Abstract
OBJECTIVE: To comprehensively update and survey the current provision of recovery, rehabilitation and follow-up services for adult critical care patients across the UK. DESIGN: Cross-sectional, self-administered, predominantly closed-question, electronic, online survey. SETTING: Institutions providing adult critical care services identified from national databases. PARTICIPANTS: Multiprofessional critical care clinicians delivering services at each site. RESULTS: Responses from 176 UK hospital sites were included (176/242, 72.7%). Inpatient recovery and follow-up services were present at 127/176 (72.2%) sites, adopting multiple formats of delivery and primarily delivered by nurses (n=115/127, 90.6%). Outpatient services ran at 130 sites (73.9%), predominantly as outpatient clinics. Most services (n=108/130, 83.1%) were co-delivered by two or more healthcare professionals, typically nurse/intensive care unit (ICU) physician (n=29/130, 22.3%) or nurse/ICU physician/physiotherapist (n=19/130, 14.6%) teams. Clinical psychology was most frequently lacking from inpatient or outpatient services. Lack of funding was consistently the primary barrier to service provision, with other barriers including logistical and service prioritisation factors indicating that infrastructure and profile for services remain inadequate. Posthospital discharge physical rehabilitation programmes were relatively few (n=31/176, 17.6%), but peer support services were available in nearly half of responding institutions (n=85/176, 48.3%). The effects of the COVID-19 pandemic resulted in either increasing, decreasing or reformatting service provision. Future plans for long-term service transformation focus on expansion of current, and establishment of new, outpatient services. CONCLUSION: Overall, these data demonstrate a proliferation of recovery, follow-up and rehabilitation services for critically ill adults in the past decade across the UK, although service gaps remain suggesting further work is required for guideline implementation. Findings can be used to enhance survivorship for critically ill adults, inform policymakers and commissioners, and provide comparative data and experiential insights for clinicians designing models of care in international healthcare jurisdictions.
Keywords
Rehabilitation Medicine, Adult Intensive & Critical Care, Humans, Critical Illness, Follow-Up Studies, Cross-Sectional Studies, Research Report, Pandemics, United Kingdom, COVID-19, SARS-CoV-2
Sponsorship
University of Cambridge (PD-2019-02-16)
Identifiers
PMC8491421, 34607869
External DOI: https://doi.org/10.1136/bmjopen-2021-052214
This record's URL: https://www.repository.cam.ac.uk/handle/1810/330390
Rights
Attribution-NonCommercial 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc/4.0/
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