The 2019 neuro-rehabilitation implementation framework in Ireland: Challenges for implementation and the implications for people with brain injuries

• Published in: Health policy (Amsterdam) 2020-03, Vol.124 (3), p.225-230
• Main Authors: Burke, Sara, McGettrick, Grainne, Foley, Karen, Manikandan, Manjula, Barry, Sarah
• Format: Article
• Language: English
• Subjects: Acquired brain injury (ABI); Brain injured people; Health administration; Health care policy; Health policy process; Health system reform; Implementation; Injuries; Ireland; Neuro-rehabilitation services; Policy implementation; Policy making; Political priority; Rehabilitation; Services; Tracking; Traumatic brain injury
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2019.12.018

•Early access to specialised neurorehabilitation services provides better health outcomes.•Rehabilitation services are a low priority for governments.•Low political priority of rehabilitation services has resulted in poor policy implementation in Ireland.•Poor access to fragmented rehabilitations services is contributed by low policy priority.•Better data, voice, visibility of people with brain injury and advocacy is needed. In 2019, eight years after the publication of Ireland’s first neuro-rehabilitation strategy, an implementation framework was published. This paper describes and assesses the Irish health policy journey to the publication of the 2019 Implementation Framework with a particular focus on tracking the rehabilitation needs of people with acquired brain injury (ABI). Internationally, rehabilitation services are a low priority for governments, with policy makers having limited knowledge and understanding of rehabilitation. This low political priority and policy understanding contributes to under-developed and poorly co-ordinated services for people who need neuro-rehabilitation services, including people with Acquired Brain Injury (ABI). Despite the publication of the 2019 neuro-rehabilitation implementation framework, key challenges remain for people with ABI in Ireland, including the absence of services across the ‘pathway’, the under-resourcing of specialist rehabilitation services, the impact on the lives of people with brain injury of poor or no access to services, and the lack of good data on this population. The paper concludes with recommendations on how increased political priority of the rehabilitation needs of people with ABI could enhance implementation of the neuro-rehabilitation implementation framework.