A study of mapping usual care and unmet need for vocational rehabilitation and psychological support following major trauma in five health districts in the UK

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Kettlewell, J., Timmons, S., Bridger, K. ORCID: 0000-0002-4215-4927, Kendrick, D., Kellezi, B. ORCID: 0000-0003-4825-3624, Holmes, J., Patel, P. and Radford, K., 2020. A study of mapping usual care and unmet need for vocational rehabilitation and psychological support following major trauma in five health districts in the UK. Clinical Rehabiliation. ISSN 0269-2155

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Official URL: https://doi.org/10.1177/0269215520971777

Abstract

Objective: Traumatic injuries are common in working age adults. Survivors may experience physical and psychological problems that affect their ability to work. Rehabilitation pathways are complex, and it is unclear whether adequate vocational/psychological support exists post-injury.

Aim: To understand where and how trauma survivors' rehabilitation needs are met post-trauma, and map rehabilitation across five UK major trauma networks.

Design: Qualitative study (interviews, focus groups, workshops) using soft-systems methodology to map usual care across trauma networks and explore service gaps. Publicly available documents were consulted. CATWOE (Customers, Actors, Transformation, Worldview, Owners, Environment) was used as an analytic thematic framework to explore the relationship between stakeholders in the pathway.

Setting: Five major trauma networks across the UK.

Subjects: 106 key rehabilitation stakeholders (service providers, trauma survivors) were recruited to interviews (n=46), focus groups (n=4 groups, 17 participants) and workshops (n=5 workshops, 43 participants).

Interventions: None.

Results: Mapping of rehabilitation pathways identified several issues: 1) lack of vocational/psychological support particularly for musculoskeletal injuries; 2) inconsistent service provision in areas located further from major trauma centres; 3) lack of communication between acute and community care; 4) long waiting lists (up to 12 months) for community rehabilitation; 5) most well-established pathways were neurologically focused.

Conclusions: The trauma rehabilitation pathway is complex and varies across the UK with few, if any patients following an 'ideal' pathway. Services have developed piecemeal to address specific issues, but rarely meet the needs of individuals with multiple impairments post-trauma, with a lack of vocational rehabilitation and psychological support for this population.

Item Type:

Journal article

Alternative Title:

A study of mapping usual care and unmet need for vocational rehabilitation and psychological support following traumatic injuries in five health districts in the UK [working title]

Publication Title:

Clinical Rehabiliation

Creators:

Kettlewell, J., Timmons, S., Bridger, K., Kendrick, D., Kellezi, B., Holmes, J., Patel, P. and Radford, K.

Publisher:

SAGE Publications

Date:

23 November 2020

ISSN:

0269-2155

Identifiers: