Deficiencies in rehabilitation after traumatic brain injury
BMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7533.118-a (Published 12 January 2006) Cite this as: BMJ 2006;332:118
- Peter J Hutchinson, senior academy fellow (pjah2{at}cam.ac.uk),
- John D Pickard, professor of neurosurgery
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 2QQ
- Department of Clinical Neurosciences, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 2QQ
Editor—Fleminger and Ponsford in their editorial on long term outcome after traumatic brain injury highlight the need for more attention to be paid to neuropsychiatric functioning. 1 The authors say that early assessments after injury concentrate more on physical disability than cognition.
Our experience is that neither is tackled adequately. In 2000 we set up the Eastern Region Head Injury Study Group to quantify the requirements of patients with traumatic brain injury. This has identified major deficiencies in the rehabilitation of these patients with absolutely no provision for rapid assess rehabilitation in the east of England. 2 The tendency for patients being left to languish on general medical, surgical, and orthopaedic wards continues to their detriment and to the detriment of those requiring admission to acute district general hospital beds. In a six month period, 37 patients with major head injury were transferred back from the regional neurosurgical unit to inappropriate district general hospital beds and within the regional neurosurgical unit, 1500 bed days were occupied by patients who were appropriate for acute rehabilitation.3
Furthermore, this represents the needs of severely injured patients. The rehabilitation needs of the much larger cohort of moderately injured patients in our region is currently unknown. We support the arguments of Fleminger and Ponsford, but neuropsychiatry sequelae are only a small component of the much larger problem of physical, cognitive, and vocational rehabilitation. We anxiously await the deliberations of the implementation group for the national service framework for long term conditions.
Footnotes
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Competing interests None declared.