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

Connolly, B. 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), e052214. (doi: 10.1136/bmjopen-2021-052214) (PMID:34607869) (PMCID:PMC8491421)

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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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Quasim, Professor Tara and McPeake, Dr Jo
Authors: Connolly, B., Milton-Cole, R., Adams, C., Battle, C., McPeake, J., Quasim, T., Silversides, J., Slack, A., Waldmann, C., Wilson, E., and Meyer, J.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in BMJ Open 11(10):e052214
Publisher Policy:Reproduced under a Creative Commons licence

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