May 17, 2020

Developing a more effective approach to vocational rehabilitation

vocational rehabilitation
employers
NHS
private sector
Admin
2 min
UK Rehabilitation Council
Written by Mark Baylis, UK Rehabilitation Council Vocational and clinical rehabilitation – especially getting injured and sick people back to wor...

Written by Mark Baylis, UK Rehabilitation Council

Vocational and clinical rehabilitation – especially getting injured and sick people back to work – is an area in which the UK lags behind most other economically advanced countries. Although there are many other reasons for this, key factors include rehabilitation being a lower priority within the UK’s National Health Service (NHS), and a disjointed approach to the different services that help people on the journey back to independence.

The private sector is increasingly moving into the vacuum created by the low level of state provision, in terms of both funding and care provision. The insurance industry led the way with the publication in 1999 of the Rehabilitation Code, which provides a legal framework for care to begin even while the two sides are still negotiating the size of any personal injury damages. The claimant lawyer community, initially unsure of the insurers’ motives, has given the initiative its wholehearted support.

Employers, meanwhile, are steadily increasing their use of rehabilitation, again using private sector providers. Many can see the advantages in terms of productivity, staff continuity and morale. Again, the insurance industry is playing an important role. Nearly all the big players in the market have embedded an element of rehabilitation into their Employers’ Liability and Income Protection policies and many go so far as to offer financial incentives, in terms of lower premiums, to employers who use rehabilitation.

Despite these advances it has to be acknowledged that the uptake of rehabilitation has risen at a painfully slow rate – and this is where there is a continuing opportunity for the healthcare sector. Sickness absence costs the UK economy an estimated £16.8 billion annually, which represents direct costs of £595 per employee per day plus indirect costs of £465.

Employers, including the public sector, remain reluctant to become engaged with rehabilitation. This is partly because of regulatory and taxation obstacles, but mostly it reflects deep-seated inertia and a feeling that it is too much trouble.

Yet there are some glittering success stories. Last year, for example, Rentokil announced it had saved 30 years of absence as a result of its rehabilitation programme with the enthusiastic backing of the workforce and unions.

The UK Rehabilitation Council, an umbrella charity for organisations that support rehabilitation, has a shared interest with the private healthcare sector in seeing more employers embrace the concept. To assist the process it has produced its own standards, which are designed to help people who purchase and commission rehabilitation.   

Mark Baylis is deputy chair of the UK Rehabilitation Council, www.rehabcouncil.org.uk

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Jun 15, 2021

 NHS trials test that predicts sepsis 3 days in advance 

sepsis
MachineLearning
clinicaltrial
blooddisorder
2 min
Queen Alexandra Hospital is trialling a new sepsis test by Presymptom Health that uses machine learning to detect the onset of the disease

A new test that can predict sepsis before the patient develops symptoms is being trialled at a National Health Service (NHS) hospital in the south of England. 

Clinicians at Portsmouth’s Queen Alexandra Hospital are leading medical trials of the blood test, which they hope will help them save thousands of lives a year. 

The test is being developed by government spin-out company Presymptom Health, but the research began over 10 years ago at the Defence Science and Technology Laboratory (Dstl). This included a study of 4,385 patients and more than 70,000 samples, the largest study of its kind at the time. 

From the samples taken, a clinical biobank and database were generated and then mined using machine learning to identify biomarker signatures that could predict the onset of sepsis. The researchers found they were able to provide an early warning of sepsis up to three days ahead of illness with an accuracy of up to 90%.

Unlike most other tests, Presymptom Health identifies the patient’s response to the disease as opposed to detecting the pathogen. This is an important differentiator, as sepsis occurs as a result of the patient's immune system’s overreaction to an infection or injury, which can then cause life-threatening organ dysfunction. 

Worldwide, an estimated 49 million people a year contract sepsis, while in the UK almost two million patients admitted to hospital each year are thought to be at risk of developing the condition. If Presymptom's test is effective, it could save billions of pounds globally and improve clinical outcomes for millions of sepsis patients.

The initial trials at Queen Alexandra Hospital will last 12 months, with two other sites planned to go live this summer. Up to 600 patients admitted to hospital with respiratory tract infections will be given the option to participate in the trial. The data collected will be independently assessed and used to refine and validate the test, which could be available for broader NHS use within two years. 

If successful, this test could also identify sepsis arising from other infections before symptoms appear, which could potentially include future waves of COVID-19 and other pandemics.

Dr Roman Lukaszewski, the lead Dstl scientist behind the innovation, said: “It is incredible to see this test, which we had originally begun to develop to help service personnel survive injury and infection on the front line, is now being used for the wider UK population, including those fighting COVID-19.”

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