The National Institute for Health and Care Excellence (NICE) has published a draft guideline aimed at standardising rehabilitation services across five chronic neurological conditions.
The guidance covers brain injury, spinal cord injury, peripheral nerve disorder, progressive neurological disease, and functional neurological disorder.
NICE said the guidance addresses “widespread variation” in services and highlighted that poor coordination of rehabilitation in England often prevents continuity of care and leads to poor physical and cognitive functioning.
An estimated 1 in 6 people in the UK live with at least one neurological condition.
Multidisciplinary and Holistic Care Encouraged
The guideline, which is open for consultation, calls for a multidisciplinary approach to holistically address individual needs. This may include physical, occupational, speech and cognitive therapies, as well as psychological support and vocational counselling.
“We encourage the neuro community to engage with the draft, so the final guideline reflects the realities of living with a neurological condition,” said Georgina Carr, chief executive of the Neurological Alliance, in a press release.
Improving Service Coordination
The NICE committee noted that poor coordination often stems from a lack of communication and collaboration between NHS and non-NHS services.
It recommended greater information sharing, coordinated working, and service level agreements. Re-access to services should also be simplified and more consistent to support timely intervention and minimise functional deterioration. Evidence suggested that early assessment — immediately after diagnosis or suspicion of a chronic neurological disorder — can slow symptom progression.
Better Access and Communication
The draft guidance recommends that each of England’s 42 integrated care boards should appoint complex case managers. Patients should also have a single point of contact for rehabilitation services.
Community service collaboration is recommended, including coordination across health, social care, and education services for children.
The committee noted that communication with patients and families varies significantly.
The draft guidance highlighted that poor communication can limit access to care and support services.
Other recommendations include providing tailored information on conditions, rehabilitation needs, service access, and third-sector organisations and advice on work, education, housing, benefits, and legal support.
A Holistic Approach
Evidence reviewed by the committee suggested that current appointments for rehabilitation focus too heavily on biomedical functioning. NICE recommended a more holistic assessment covering pain, fatigue, cognitive function, and mental wellbeing, as well as limb function.
Interventions should include psychological therapies, speech-language therapy, sleep advice, and task-based training.
Assessments should also consider a patient’s ability to work and engage in social and leisure activities, family life, and friendships.
The committee acknowledged that implementing these changes may require more staff time and place pressure on existing services.
However, they noted that early and appropriate intervention could reduce the need for crisis care, potentially easing long-term service demands.
NICE said it expected to publish final draft guidance in September 2025.
Annie Lennon is a medical journalist. Her writing appears on Medscape, WebMD, and Medical News Today, among other outlets.