Rehabilitation and the challenges of limited services

  • Female nurse helping a young man walk
Department of Health Queensland
Jennifer Finch
Director Allied Health
Allied Health Professions’ Office of Queensland
Clinical Excellence Queensland

In October of 2020, the Allied Health Professions’ Office of Queensland and the Statewide Rehabilitation Clinical Network from Clinical Excellence Queensland teamed up with the Hopkins Centre, Griffith University to explore some of the implications of the health services response to COVID 19 on Queensland public health rehabilitation services and health professionals.

Of the 123 health professionals who responded to our survey, 28 were from non-metropolitan areas. While the findings covered a range of issues, we noticed that rural respondents emphasised some key concerns regarding technology and discharging patients.

Both metro and non-metro participants expressed concern that the health service responses to the COVID threat had resulted in many patients’ rehabilitation journeys being disrupted or truncated. Across all respondents, there was some apprehension about potentially slower recovery, constrained outcomes and possible complications due to patients receiving less rehabilitation.

In the context of pressure to move patients out of rehabilitation, for many non-metropolitan professionals, that meant transitioning patients out of larger regional hospitals and “closer to home” (either transferred to a smaller regional facility or discharged home). In parallel, many described increased use of telehealth in transition, discharge and outpatient services. Across survey participants, it seemed that proportionally more of the non-metro participants actively explored telehealth options. Paradoxically these rural and remote rehabilitation professionals described the challenges of limited experience with telehealth and with software and internet bandwidth impacting communications. They also described less availability of community services and resources than previously. Even though the non-metropolitan rehabilitation professionals actively sought creative options, the existing technological and community service constraints were amplified.

The COVID 19 threat has been an opportunity for a number of rural rehabilitation professionals and patients to test out the potential of telehealth. Our survey suggests that for it to be a tangible alternative, it needs to be supported with adequate hardware, software and bandwidth. It needs to be supported with adequate skills and experience. Importantly, it also needs to be supported with adequate community services.

On the basis of our survey, we concluded that in the face of external threats such as a pandemic or natural disaster, as people are more geographically confined, they need better connections and more localised solutions. Investment in telehealth resources and skills, and investment in local and community services are important elements which would enhance rehabilitation and subacute services and outcomes particularly for rural and remote communities.

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