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2 Specialties Rehabilitation medicine4 Rehabilitation medicine requires MDTs. A centreshould include at least two RM consultants(single-handed practice is undesirable).5 Rehabilitation medicine must be recognised as aresource for both hospital and community services.Specialist medical involvement is essential whereverdisabilities are complex – for example, amputationrehabilitation. Advice on rehabilitation medicine isoften crucial for cost-effective delivery of assistivetechnologies.6 There should be 45–60 beds per million population,depending on how services such as stroke areprovided. The recommended minimum size for aninpatient unit is about 20 beds.7 The special character of RM does not fit well with astandard medical job plan. In RM, more time mustbe allocated for clinical administration, interagencycoordination, home visits and servicedevelopment.References1 Royal College of Physicians. Medical rehabilitation in2011 and beyond. London: RCP, 2010.2 Royal College of Physicians. Physical disability in 1986and beyond. London: RCP, 1986.3 World Health Organization. WHO Internationalclassification of functioning, disability and health (ICF).Geneva: WHO, 2007. www.who.int/classifications/icf/en/[Accessed 28 June 2011].4 Royal College of Physicians. Long-term neurologicalconditions: management at the interface betweenneurology, rehabilitation and palliative care.Nationalguidelines. Concise guidance series No 10. London: RCP,2008.5 Department of Health. National service framework forlong-term conditions. London: DH, 2005. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH 4105361 [Accessed28 June 2011].6 Department of Health. Transforming communityequipment services: enabling new patterns of provision.London: DH, 2009. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH 093197 [Accessed 28 June 2011].7 Department of Health. Equity and excellence: liberatingthe NHS. London: DH, 2010. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH 117353 [Accessed 28 June 2011].8 Turner-Stokes L, Disler P, Nair A, Sedki I, Wade D.Multi-disciplinary rehabilitation for acquired braininjury in adults of working age. Cochrane Database SystRev 2005;(3):CD004170.9 KhanF,Turner-StokesL,NgL,KilpatrickT.Multi-disciplinary rehabilitation for adults with multiplesclerosis. Cochrane Database Syst Rev 2007;(2):CD006036.10 Department of Health. Supporting people withlong-term conditions. An NHS and social care model tosupport local innovation and integration. London: DH,2005. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH4100252 [Accessed 28 June 2011].11 Royal College of Physicians, Royal College of GeneralPractitioners. Making the best use of doctors’ skills – abalanced partnership. London: RCP, 2006.12 Department of Health. The operating framework for theNHS in England 2011/12. London: DH, 2010.www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH 122738 [Accessed28 June 11].13 Black A. The future of acute care. NHS Confederation.Clin Med 2005;4:10–12.14 Department of Health. Healthy lives healthy people: ourstrategy for public health in England. London: DH, 2010.www.dh.gov.uk/en/Publichealth/Healthyliveshealthypeople/index.htm [Accessed 28 June 2011].15 Department of Health, Department for Work andPensions, Health and Safety Executive. Health, work andwell-being – caring for our future. London: HM Government,2006. www.dwp.gov.uk/docs/health-andwellbeing.pdf[Accessed 28 June 2011].16 British Society of Rehabilitation Medicine.Undergraduate medical education in rehabilitationmedicine. London: BSRM, 2006.17 Joint Royal Colleges of Physicians Training Board.Specialty training curriculum for rehabilitation medicine.London: JRCPTB, 2010. www.jrcptb.org.uk/specialties/ST3-SpR/Documents/2010%20Rehabilitation%20Medicine%20Curriculum.pdf [Accessed 28 June 2011].18 Turner-Stokes L. Clinical governance in rehabilitationmedicine. The state of the art in 2002. Clin Rehabil2002;16(suppl 1):13–20.19 Barnes MP, Radermacher H. Community rehabilitation.Cambridge: Cambridge University Press, 2003.20 Turner-Stokes L. The effectiveness of rehabilitation: acritical review of the evidence. Introduction. Clin Rehabil1999;13(suppl 1):3–6.21 Royal College of Physicians, British Society ofRehabilitation Medicine. Rehabilitation followingacquired brain injury. National clinical guidelines.London: RCP, 2003.22 British Society of Rehabilitation Medicine. Standards forspecialist inpatient and community rehabilitation services.London: BSRM, 2002. www.bsrm.co.uk/ClinicalGuidance/ClinicalGuidance.htm [Accessed 6 June2011].C○ Royal College of Physicians 2013 211
Consultant physicians working with patients23 British Society of Rehabilitation Medicine. Amputee andprosthetic rehabilitation – standards and guidelines.London: BSRM, 2003.24 Royal College of Physicians, British Society ofRehabilitation Medicine. Chronic spinal cord injury:management of patients in acute hospital settings.London:RCP, 2008.25 Royal College of Physicians. Spasticity in adults:management using botulinum toxin. National guidelines.London: RCP, 2008.26 British Society of Rehabilitation Medicine. Vocationalassessment and rehabilitation for people with long-termneurological conditions: recommendations for best practice.London: BSRM, 2010.27 National Institute for Health and Care Excellence.Multiple sclerosis: management of multiple sclerosis inprimary and secondary care. Clinical guideline 8. London:NICE, 2003.28 NICE. Rehabilitation after critical illness. Clinicalguideline 83. London: NICE, 2009.29 Turner-Stokes L, Sutch S, Dredge R. Healthcare tariffs forspecialist inpatient neurorehabilitation services: rationaleand development of a UK casemix and costingmethodology. Clin Rehabil (in press).30 Skinner A, Turner-Stokes L. The use of standardisedoutcome measures in rehabilitation centres in the UK.Clin Rehabil 2006;20:609–15.31 Royal Colleges of Physicians. Census of consultantphysicians in the UK, 2003: data and commentary.London: RCP, 2003.212 C○ Royal College of Physicians 2013
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AbbreviationsA&EAACsAMUsARCPCCGsCCS
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