The Definition of Specialist Services:

In the wake of the Carter Review (2006), the Department of Health has been revising its Specialised Services National Definition Set (SSNDS). The Third Edition definition: No 7 Brain Injury and Complex Rehabilitation, identifies three main levels of service;

• Level 1: Specialised (tertiary) rehabilitation services serving a catchment population > 1 million population and carrying a high proportion of complex cases and reporting the full clinical dataset to the UKROC database (Click here for the UK DATASET). These will probably be designated by the National Specialised Commissioning Group (NSCG).
• Level 2: Local specialist rehabilitation services serving a population of 250K – 1 million, carrying a lower proportion of complex cases and reporting at least the minimum clinical dataset to the UKROC database.
• Level 3: Non-specialist rehabilitation services serving a local population (usually <500K) led by therapists or non-Rehabilitation medicine consultants.
  • Level 3a: services are local services which ‘specialise’ in certain conditions and include a significant component of rehabilitation (for example stroke, or care of the elderly). They are led / supported by consultants in specialties other than Rehabilitation Medicine (e.g. neurology / stroke medicine) and may act as a local source of expertise, even though they do not meet the full standards for a ‘specialist rehabilitation service’.
  • Level 3b: services are non-medically led services for example in intermediate care settings.

It has been suggested that Level 2 should be further subd-divided into:

• Level 2a: Supports supra-district catchment population of 750K or more and takes a proportion of patients with very complex needs. Level 2a reports full clinical dataset to the UKROC database and submits UKROC data monthly to nwlh-tr.ukroc@nhs.net
• Level 2b: A district service with a catchment population of <750K and has a lower proportion of complex cases. Level 2b services report a minimum dataset to the UKROC database and submits data quarterly (June, September, December and March).

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