Abstract
Background
Access to regional specialist services to support complex management needs (including spasticity) in the community is often variable in the UK and internationally. There are barriers to service access due to condition severity, resulting in inequity of provision.
Methods
Service data covering a six-year period were extracted from a clinical database (2019–2025) from a regional service offering specialised community outreach (London and surrounding counties, UK). Yearly caseload, clinical activity and activity time were all calculated for the cohort. Method of delivery: face-to-face, telephone or virtual and type of assessment or review per year were counted and classified.
Results
Activity doubled during the 6-year period (
n
= 360 (2019–20),
n
= 728 (2024–25). The primary reasons for referral were spasticity management (
n
= 2821), and/or complex physical management (
n
= 2393). Other issues addressed were splinting or orthotics, re-assessment of Prolonged Disorders of Consciousness, management of pressure sores, communication and swallowing, wheelchairs and postural management.
Conclusions
There is expanding utilisation to support and manage severe and complex disability for those with stroke and other acquired brain injury in the community, particularly for spasticity and contracture management. Service delivery partnership between specialised services and local rehabilitation services or teams, is likely to be key to providing more seamless care.