“Take care of this knee. When you leave the hospital after surgery, that’s only half the job done”.
My mum and I took in her surgeons words attentively. With her ‘frequent flyer’ badge at her local hospital, we’re both very aware of how stretched the NHS is for both funding and resources. We felt so grateful for the excellent surgeon, and the incredible team who supported the complex knee operation. But his words have stuck with me long after we left. If acute care is only ‘half the job’, are we doing enough to make sure the job gets finished?
Rehab is a no brainer from the perspective of patient centred care. Whether it’s physiotherapy, occupational therapy, or peer support, rehab helps people live life to the fullest. It helps us maintain independence and follow the things that matter most to us. From an economic perspective, when the NHS has to make every penny count, we have a responsibility to make sure that it’s spent well. Spending money on rehab to give people the best outcomes keeps them out of hospital for longer and ensures they have the best recovery. Anything less is a job half done.
Over the last year, Chest Heart and Stroke Scotland (CHSS) has published a series of research papers showing that fewer than half (45%) of people with our chest, heart and stroke conditions and Long Covid are getting access to rehab. These conditions are some of Scotland’s big hitters – heart disease is our leading cause of death, stroke remains a leading cause of adult disability, and respiratory conditions like COPD are the single biggest cause of emergency admissions, making up 1 in 7 admissions. So if we want to keep people out of hospital, access to effective rehab is essential.
At CHSS, we know it’s the time after the diagnosis, after we get home, when we need support the most. Without access to proper support, people with long term conditions like ours often feel low, isolated and anxious. As the largest organisation in Scotland supporting people with chest heart and stroke conditions, our mission is to ensure that everyone gets the support they need to live life to the full. It’s why we have focussed our services around supported self management, so that everyone gets the support and skills they need to manage their health. It’s also why we’re a core member of the Right to Rehab coalition, campaigning to ensure that everyone gets the rehab they need for as long as they need it.
In this year’s Programme for Government, a long held commitment from the Scottish Government to incorporate key human rights treaties into law was quietly dropped. This legislation would have made the Right to Health a claimable right in Scots Law, and could have helped more people claim the rehab that they need. For many of us who have campaigned for this, it was devastating to see this commitment go not with a bang, but with a whimper. Health feels like less of a right than ever, and we desperately need to do more to help people stay healthier for longer.
If Scottish Government won’t be bringing forward legislation to strengthen the right to health and access to rehab, then it needs to find other ways to help realise this right. Increasing access to rehab means reducing readmissions, reducing disability, ensuring resources are well spent – but most importantly, it is helping everyone live life to the fullest. We must make sure that everyone who needs it gets access to the rehab they need – anything else is a job half done.
If you or anyone you know is living with a chest, heart or stroke condition or Long Covid and is looking for advice and support contact the CHSS Advice Line on 0808 801 0899 or on adviceline@chss.org.uk