Six Months of our Integrated Rehabilitation Centre: Reflection by Dr. Neil Langridge

In October 2022, AECC University College officially opened its state-of-the-art Integrated Rehabilitation Centre. In the months that followed, the University College launched its suite of Clinical and Rehabilitation Services and our multi-disciplinary team welcomed patients through the doors.

The team includes Physiotherapists, Chiropractors, First Contact Practitioners, Sports Rehabilitators, Radiographers, and Sports Scientists.

We offer a free enquiry triage model, as part of which prospective patients speak to a Senior Clinician and are advised which service would be most helpful for them.

Director of Clinical and Rehabilitation Services, Dr. Neil Langridge, reflects on the first six months:

First Six Months

“Six months on, we’re much further ahead than I thought we would be and that’s down to the team of individuals that we’ve been able to recruit, from across different health professions.

“I’m particularly proud of our enquiry triage model. It’s free to access and we’re aiming to put patients in the right space, with the right person, at the right time. That’s the key to allowing us to do things differently for patients in a fair way.

“Belonging to AECC University College, we have a strong focus on clinical education and we’re giving experience to the clinicians of tomorrow. There’s also an altruistic component to our offer, because we have a community focus.”

Three-Step Treatment Process

“We are keen not to label people by their condition; instead, we want to create a whole care package for patients. Rehabilitation should include a whole range of different services that come to the patient.

“At AECC University College, we have a three-step treatment process: taking patients through the stages of limitation and rehabilitation and into performance and or function.

“If a patient is in the limitation stage, they might be limited by pain, worry or fear. As clinicians, we work to try and solve that with the patient. Rehabilitation is essentially about giving our patients the tools to work through their recovery. When they reach the performance stage, patients are most likely ready to carry on by themselves: there’s nothing limiting them anymore.

“That’s what supported rehabilitation is all about and that’s what we’re trying to do here.

“In our model, whichever clinician you see initially becomes your case manager. It could be a Sports Rehabilitator or a Sports Scientist, it doesn’t matter. The role of that case manager is to understand your condition and all of the treatment options available, explain those, and help you to choose any of the options in any particular order or combination that works for you; and then work with the range of health professionals to bespoke the care needed.”

History of Rehabilitation

“If we go back historically, rehabilitation was itself an area of specialism within the NHS. As Physiotherapy grew into an extension role, incorporating new elements such as injecting, prescribing drugs, requesting MRIs, the profession moved away from rehabilitation as a sole service by necessity.

“Rehabilitation became the responsibility of professionals who were under a lot of time and capacity pressure. To learn and develop their skills, clinicians should ideally be able to see somebody through a whole period of rehabilitation; that’s how you learn about prognosis, and learn management reasoning.

“In reality, there was significant pressure to see patients quickly and to move them on as soon as possible. As a result, these clinicians were not learning the skills to see patients through recovery, developing an understanding of which patients would respond better to supported rehabilitation, and which would prefer self-management.

“This has led to a belief system within the Physiotherapy profession that patients should be – quite rightly – empowered to self-manage. But I believe that we are pushing people into that too quickly. Patients are often left in the community to manage their rehabilitation themselves, which is a difficult thing for them to do.”

Supported Rehabilitation

“Supported rehabilitation is the psychological and emotional support that clinicians can give to patients whilst they go through a recovery process. The clinician adds in functional tasks and recovery exercise to give patients the capacity to see an endpoint.

“The clinician helps the patient to regain their confidence as their function improves. As the patient’s function improves, they gain confidence and have greater resilience. Without that emotional and psychological support, some patients can get stuck in recovery.

“This requires the clinician to build a therapeutic alliance with the patient and it’s possible to do that quickly.

“This alliance is built on trust. When you see a limitation that is based upon fear, prescribing exercise alone is not going to be enough.”

Clinical Education

“Clinical Education is central to what we’re doing here. We have plans in place to offer placements in all our services adding to the Chiropractic and imaging provision. What we’re trying to do is offer experiences that meet and reflect our ethos.

“Physiotherapy students for example shouldn’t just be allocated to our Physiotherapists; I’d like them to have some time with our Sports Scientist, some time spent running exercise classes, and some time with the Chiropractic team.

“To be creating really strong health care professionals of tomorrow, we need to be producing interprofessional clinicians that have a central core of practice. That’s what we’re working on developing.

“We might call them enrichment opportunities: opportunities for our students to really break out from their own core skills that they are learning and to broaden their awareness of what the health service involves. The better your interprofessional behaviours, the better you will serve your patients. That’s a central aim for us.”

Community focused health care

“We’re also looking at ways that we can be designing our services based on population health. The services that we are offering have the capacity to be set up for whatever our population health challenges are.

“We’re keen to understand where the gaps are in the NHS locally, so that we can support the health service and patients where they aren’t currently able to deliver. I see our role in our local community as providing affordable health care that is accessible for patients when the NHS isn’t able to support them in the way that they need.

“These past six months have been a fantastic start to the service that we are offering. I’m excited to see where we’ll be by the end of the first year and in the next five years, as we continue to deliver a patient-focused service that wraps around the user.”

You can read more about our Clinical and Rehabilitation Services here.