The National Institute for Health and Care Excellence (NICE) has recently published comprehensive new guidelines (NG252) on rehabilitation for children and adults with chronic neurological disorders.

The guidance emphasises a holistic, person-centred approach to rehabilitation, spanning physical, cognitive, emotional, and social needs. It covers many conditions commonly encountered in catastrophic injury claims, such as traumatic brain injury, spinal cord injury, and functional neurological disorder (FND).

Many of NICE's recommendations will come as no surprise to those handling claims for injuries of this nature. They include early identification of rehabilitation needs, personalised goal setting, and coordinated rehabilitation plans that may extend across an injured person’s lifetime. It's expected that the injured person's rehabilitation plan will help them to maintain and improve function and to live as fully and independently as possible. To do that, rehabilitation plans should address every aspect of daily life, from pain management, cognitive function and mobility, to social activities, relationships, and education or employment. 

NICE also advocates for assigning a single point of contact, such as a key worker or complex case manager, to co-ordinate rehabilitation and support individuals with complex or fluctuating needs. They also recommend simple re-referral mechanisms that can be used to access rehab even after someone has been discharged from their services. 

This model aims to reduce fragmentation of care and improve patient outcomes. In the claims context, insurers are often happy to fund case managers to support this kind of comprehensive intervention under the Rehabilitation Code. However, sometimes injured people have been floundering in a complex, and often inflexible, NHS system for too long before that happens. It's reassuring to see recognition from NICE that this level of support should be provided to everyone dealing with a chronic neurological disorder, across the board.

The guidelines acknowledge that service provision is currently variable, and that the recommendations may have resource implications, particularly due to shortages of skilled staff within neurorehabilitation and mental health services. It's clear that the current funding crisis in the NHS shows no sign of abating, so it remains to be seen how these recommendations will be implemented in practice. However, there is no doubt that early and effective rehabilitation can have a hugely positive impact - of course on patient outcomes, but also by extension on reducing long term costs. Clearly, that's a goal which insurers and the taxpayer have in common.

In summary, the NICE Guidelines NG252 are a positive development, particularly in cases where liability is disputed and private funding isn’t available as it ensures injured individuals still have access to meaningful rehabilitation via the NHS. However, insurers should be aware that claimants and their legal teams may use NG252 to justify broader (and potentially more costly) private rehabilitation packages, especially where NHS services are delayed or limited. While NG252 provides useful guidance, it remains just that: a guideline. Requests for private funding under the Rehabilitation Code should still be assessed individually, with consideration given to the specific needs of the claimant and the circumstances of the case.