Organization of rehabilitation services

In the past 20 years there have been many changes in the way that neurological rehabilitation is delivered worldwide. This is in part a reflection of improved acute medical therapies and intensive care and also related to the development of a more holistic approach to recovery, embracing the principles of the WHO International Classification of Functioning as a model for rehabilitation. Traditionally, rehabilitation services have tended to develop piecemeal according to local resources and need. By definition such services should be driven by a patient-centered approach and thus there is wide variety in service provision nationally and internationally. This chapter describes the background to current service set-ups and provision, exploring models of rehabilitation delivery and common presentations in neurological rehabilitation. Relevant legislation and guidance documents are reviewed. The text provides an overview of different aspects of rehabilitation services including acute and inpatient provision, outpatient services, community-based rehabilitation, residential facilities, and vocational services.