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National Strategy & Policy for the Provision of Neuro-Rehabilitation Services in Ireland

From theory to action 

 Implementation Framework 2019-2021 

The National Steering Group (NSG) supporting the implementation of the National Strategy & Policy for the Provision of Neuro-Rehabilitation Services in Ireland are delighted to present the implementation framework for the Strategy. The NSG includes representatives from Disability Services Strategy and Planning, the National Clinical Programme for Rehabilitation Medicine, Acute Hospital Services, Primary Care Division, Mental Health Division, Neuro-Psychiatry, Health and Social Care professionals, National Rehabilitation Hospital (NRH), Health & Wellbeing Division, Public Health and the Neurological Alliance of Ireland (NAI).

This National Implementation Framework describes the fundamental principles of design and service delivery required to implement the Strategy. The Implementation Framework, which is a 3 year plan, has been built on a 10-step programme which encompasses clear governance structures, population planning and a mapping approach to inform the service development requirements to improve the quality of life of people living with neurological conditions.

 The development of specialist rehabilitation services is everybody’s business. While the implementation of the Strategy is being led jointly by the office of Disability Services Strategy and Planning and the Clinical Programme & Strategy Division, this strategy cannot be viewed in isolation. It needs to be considered in terms of a number of services strategies currently being advanced across the HSE and DoH including;

  • A Trauma System for Ireland 2018- Trauma Network Policy: One of the major points highlighted in this document is that people who suffer a traumatic injury will have significant rehabilitation requirements. Trauma Networks will fail if not supported by a well-developed rehabilitation network.
  • Committee on the Future of Healthcare - Sláintecare Report May 2017: The principles outlined in this report are reflective of the Strategy’s aim specifically with respect to timely access to all health and social care according to medical need.
  • Health Service Capacity Review 2018 - Executive Report Review of Health: This document outlines the case for the development of a more integrated, proactive and community-based care model with greater provision of home care, short term respite and step-down care.

This Implementation Framework reflects the main recommendation from these and other policies as they relate to neuro–rehabilitation services.   Further supporting evidence is presented in the recently published Model of Care of the National Clinical Programme for Rehabilitation Medicine 2018, where best practice for specialist rehabilitation services across the continuum of care is clearly described. The Model of Care is one of the key reference documents informing this implementation framework.

 Evidence-based and informed by population needs, this National Implementation Framework addresses the rehabilitation continuum of care.  It describes the requirement for a whole system approach and provides the blueprint for how we should deliver care and services for those who suffer from neurological conditions who require individualised, goal focused rehabilitation.  It is recognised that continued investment in and development of neuro-rehabilitation services will need to be prioritised beyond the three year implementation period of this Implementation Framework in order to address the significant lack of capacity within existing services.

The Implementation Framework provides a structured approach and guidance to the person, nominated by the respective Chief Officer, who has responsibility for overseeing implementation at local level.  The NSG is the governing body for the implementation framework and will provide guidance and support to the local implementation teams developed in each CHO.  These teams will be required to oversee the development of a range of interdisciplinary services to provide the appropriate continuum of care across CHO, acute hospital and community rehabilitation services. It is envisaged these local service frameworks will be merged over time into a number of population based ‘Managed Rehabilitation Clinical Networks’ as the long term vision for the development of rehabilitation services.