The feasibility of indicators and targets for rehabilitation services

Abstract

The costs and burdens of disability are extremely high. It is reasonable to expect that both will be reduced by meeting appropriate targets for rehabilitation services which will also result in an improved quality of life and the prevention of further disability and unnecessary suffering. Targets which require collaboration between services are particularly powerful as agents of change because better collaboration will inevitably lead to the resolution of further problems outside the immediate target area at no additional cost.

There is general agreement that the most important goals for these services are the same as the goals formulated by disabled people themselves and relate to self-care, communication, mobility, continence, fulfilling activities (particularly employment), 'equivalent resources', the needs of those with complex disability and the needs of informal carers. Choice of treatment, and of residential options, needs to be open to the consumer for a fully satisfactory outcome to be assured.

This paper identifies 11 goal areas and argues for the selection of key indicators for this initial round of target setting. A target is suggested for each indicator. In turning this strategy into action, it is essential to ensure that health authorities and other government departments are charged with meeting these objectives and that appropriate rewards and penalties are employed to ensure reasonable compliance. Setting targets at this stage would greatly increase the information available to the Government at the next round of target-setting, and would stimulate the generation of ideas for research. Tangible improvements would be demonstrated within four years.