Recovery, rehabilitation and follow-up services following critical illness: an updated UK national cross-sectional survey and progress report.

Journal article


Connolly B, Milton-Cole R, Adams C, Battle C, McPeake J, Quasim T, Silversides J, Slack A, Waldmann C, Wilson E, Meyer J, Faculty of Intensive Care Medicine Life After Critical Illness Working Group and Bench, S. (2021). Recovery, rehabilitation and follow-up services following critical illness: an updated UK national cross-sectional survey and progress report. BMJ Open. 11, p. e052214. https://doi.org/10.1136/bmjopen-2021-052214
AuthorsConnolly B, Milton-Cole R, Adams C, Battle C, McPeake J, Quasim T, Silversides J, Slack A, Waldmann C, Wilson E, Meyer J, Faculty of Intensive Care Medicine Life After Critical Illness Working Group and Bench, S.
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.

Year2021
JournalBMJ Open
Journal citation11, p. e052214
PublisherBMJ
ISSN2044-6055
Digital Object Identifier (DOI)https://doi.org/10.1136/bmjopen-2021-052214
Web address (URL)http://europepmc.org/abstract/med/34607869
Publication dates
Online04 Oct 2021
Publication process dates
Accepted31 Aug 2021
Deposited09 Dec 2022
Publisher's version
License
File Access Level
Open
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