NICE guidance on rehabilitation after critical illness identifies patient need, access and quality of rehabilitation, both during the ICU admission and upon leaving hospital for community care. In 2014-15, the INARC Care Mix Programme reported 126,975 people were discharged after a critical care stay. Many of these people will benefit from a rehabilitation programme. Optimisation of recovery from critical illness is now a therapeutic objective (as well as survival), which requires a multiprofessional and multiple therapy approach.
Assessment of the rehabilitation needs of all patients within 24 hours of admission to critical care and eligible patients on discharge from critical care must receive a rehabilitation prescription. All patients with a tracheostomy must have communication and swallowing needs assessed when the decision to wean from the ventilator has been made. All patients are screened for delirium. Patients receiving rehabilitation are offered a minimum of 45 minutes of each active therapy that is required for a minimum of 5 days a week, at a level that enables them to meet their rehabilitation goals for as long as they are continuing to benefit from the therapy and are able to tolerate it. Patients must have all rehabilitation outcomes quantified using a tool that can track progression from the acute sector into primary care to facilitate care needs in the community.