Recovery, rehabilitation and follow-up services following critical illness: an updated UK national cross-sectional survey and progress report
Creators: name: Connolly, Bronwen
name: Milton-Cole, Rhian
name: Adams, Claire
name: Battle, Ceri
name: Quasim, Tara
name: Silversides, Jon
name: Slack, Andrew
name: Waldmann, Carl
name: Wilson, Elizabeth
name: Meyer, Joel
name: Group, The Faculty Of Intensive Care Medicine Life After Critical Illness Working
name: Barton, Greg
name: Bastin, Anthony
name: Bear, Danielle
name: Bench, Suzanne
name: Davies, Martin
name: Ferguson, Andrew
name: Firshmann, Penny
name: Gager, Melanie
name: Highfield, Julie
name: Linford, Sarah
name: McPeake, Joanne
name: Merriweather, Judith
name: Parry-Jones, Jack
name: Phillips, Margaret
name: Sanger, Helen
name: Sturmey, Gordon
name: Wade, Dorothy
Publisher: name: Apollo - University of Cambridge Repository
Year: 2021
Subjects: Intensive care
1506
1707
adult intensive &amp; critical care
rehabilitation medicine

description: Objective: To comprehensively update and survey the current provision of recovery, rehabilitation and follow-up services for adult critical care patients across the UK. Design: Cross-sectional, self-administered, predominantly closed-question, electronic, online survey. Setting: Institutions providing adult critical care services identified from national databases. Participants: Multiprofessional critical care clinicians delivering services at each site. Results: Responses from 176 UK hospital sites were included (176/242, 72.7%). Inpatient recovery and follow-up services were present at 127/176 (72.2%) sites, adopting multiple formats of delivery and primarily delivered by nurses (n=115/127, 90.6%). Outpatient services ran at 130 sites (73.9%), predominantly as outpatient clinics. Most services (n=108/130, 83.1%) were co-delivered by two or more healthcare professionals, typically nurse/intensive care unit (ICU) physician (n=29/130, 22.3%) or nurse/ICU physician/physiotherapist (n=19/130, 14.6%) teams. Clinical psychology was most frequently lacking from inpatient or outpatient services. Lack of funding was consistently the primary barrier to service provision, with other barriers including logistical and service prioritisation factors indicating that infrastructure and profile for services remain inadequate. Posthospital discharge physical rehabilitation programmes were relatively few (n=31/176, 17.6%), but peer support services were available in nearly half of responding institutions (n=85/176, 48.3%). The effects of the COVID-19 pandemic resulted in either increasing, decreasing or reformatting service provision. Future plans for long-term service transformation focus on expansion of current, and establishment of new, outpatient services. Conclusion: Overall, these data demonstrate a proliferation of recovery, follow-up and rehabilitation services for critically ill adults in the past decade across the UK, although service gaps remain suggesting further work is required for guideline implementation. Findings can be used to enhance survivorship for critically ill adults, inform policymakers and commissioners, and provide comparative data and experiential insights for clinicians designing models of care in international healthcare jurisdictions.