How can we scale up rehabilitation in Queensland?
The call for action encourages governments across the world to strengthen, extend and enhance rehabilitation as an important response to the significant and ever-increasing demand created by chronic disabling conditions.
There are a number of significant barriers that stand in the way of this objective. To strengthen and expand the availability of quality rehabilitation services, these barriers need to be addressed. Ten recommendations have been outlined by WHO that must be addressed to successfully scale up rehabilitation.
At The Hopkins Centre we want to identify the top three priorities over the next 5 years so we can do our part in addressing this call for action and solving this challenge.
The Hopkins Centre: Research for Rehabilitation and Resilience is a collaboration between academics, practitioners, policy-makers and consumers in both government and non-government sectors. Our aim is to promote bold ideas and better solutions that foster better outcomes for people with acquired and developmental disabilities in future. By building interdisciplinary and cross-sectoral partnerships, and promoting research capacity, we are generating evidence that can immediately inform improvements in policy and practice.
Background to the Challenge
On 7th February, 2017, many of the world's leading rehabilitation experts gathered in Geneva and produced “Rehabilitation 2030”, a WHO call for action to all countries to address the significant and ever-increasing need for rehabilitation services.
The need for rehabilitation is fuelled by ageing populations and the global rise of non-communicable diseases, like cerebrovascular disease, cancer, as well as traumatic injuries, substance use and associated conditions. This increasing demand is combined with historically underdeveloped and poorly coordinated rehabilitation systems in most countries.
As a result of this trend, the growing need for rehabilitation currently remains unmet in most countries. The global rehabilitation workforce is one-tenth of its recommended size. Even in well-developed systems, utilisation of services and engagement in rehabilitation is less than desired. Even using the most conservative figures, it is estimated by WHO that 74% of years lived with disability in the world could be addressed through improved and timely rehabilitation services.
In terms of access to rehabilitation, there is a stark discrepancy between high and low income countries, but within our own country, the discrepancy between high and low income regions is also significant. Large investments are being made into avoidable re-admissions to hospital, self-management of chronic conditions and lifetime disability support systems. However, we are not yet using rehabilitation services as a systematic strategy to build resilience and health for tens of thousands of vulnerable people and contribute to health promotion for the entire population.
Barriers to Scaling Up Rehabilitation
What barriers stand prevent us using rehabilitation effectively to address our rising tide of unmet need?
Rehabilitation 2030 identified a range of barriers that are relevant across the world - some are shown below. Most of these barriers are equally relevant in Queensland, Australia.
- Under-prioritisation of rehabilitation by governments amongst other competing priorities;
- Absence of rehabilitation policies and planning at the national and state levels;
- Lack of coordination between health and social sectors;
- Artificial divisions between rehabilitation systems and disability services;
- The lack of integration of rehabilitation into health, social and primary care systems;
- Non-existent or inadequate funding for rehabilitation staff, facilities and equipment;
- Poor insurance coverage for rehabilitation;
- Insufficient evidence about rehabilitation, its effectiveness and the need for rehabilitation;
- The misperception that rehabilitation is a luxury;
- The lack of standardized referral pathways and seamless transitions;
- The lack of comprehensive integrated models of rehabilitation;
- Shortage of multi- and inter-disciplinary teams and disincentives to practice in innovative ways;
- inadequate use of, access to and training in the use of assistive products and technology;
- The lack of integration between acute specialist units, transitional/community rehabilitation and long-term community disability services.
To strengthen and expand the availability of quality rehabilitation services, these barriers will need to be addressed in Queensland, Australia. This year, we have a unique opportunity to respond to the WHO call for action with the introduction of the National Injury Insurance Scheme and the National Disability Insurance Scheme.
Our Priorities for the Future
What will we need to focus on over the next 5 to 10 years to ensure that rehabilitation becomes an effective and integral service delivered to all Queenslanders who require assistance and could benefit from rehabilitation?
WHO identified ten priorities that must be addressed to successfully scale up rehabilitation. How do these priorities relate to Queensland?
- Creating strong leadership and political support for rehabilitation at local, state, national and global levels.
- Ensuring strong rehabilitation planning and implementation at national, state and local levels.
- Improving the integration of rehabilitation into the health and social sector to effectively and efficiently meet population needs.
- Ensuring that all people have access to rehabilitation services, of sufficient quality to be effective without causing financial hardship.
- Building comprehensive and equitable rehabilitation service delivery models to increase quality services.
- Developing a strong multidisciplinary rehabilitation workforce with ability to work in interdisciplinary ways and promoting rehabilitation concepts across the entire health workforce.
- Expanding financing for rehabilitation through appropriate mechanisms such as insurance and innovative budget resourcing.
- Enhancing health information systems to enable the collection and use of data relevant to rehabilitation outcomes rather than only prevalence and incidence data.
- Building research capacity and expanding the availability of robust evidence for rehabilitation.
- Establishing and strengthening networks and partnerships to support rehabilitation.
The Challenge for Hivers
What are the top THREE priorities for The Hopkins Centre over the next 5 years in scaling up rehabilitation in Queensland?
Why are these priorities are so important?
We are calling on Hivers around the world and locally to help us think through the best investment of our time and resources to achieve the WHO call for action. Can you provide information that could guide our work in addressing the recommended priorities, solving barriers and scaling up rehabilitation in Queensland:
- Examples of successful strategies or activities from other places or locally;
- Creative and innovative ideas that haven't yet been tried;
- Reasons why some barriers are particularly challenging in Queensland;
- Important steps that need to be taken to facilitate the recommended priorities;
- Suggestions for how our research centre can contribute to the solution.
Challenge Opened: 12:11 AM, Tuesday 19 September 2017
Challenge Closes: 08:00 AM, Tuesday 30 January 2018
Time to go: Closed
Documents associated with this Challenge
|File name||File type||Date uploaded||Size (KB)|
|WHO Rehabilitation in Health Systems||
|The need to scale up rehabilitation||
|Health information systems and rehabilitation||
|Call for action||