NICE’s new rehabilitation guidance: welcome ambition – but can community services keep up?

NICE has released new guidance (NG252) calling for greater access to rehabilitation across community settings. It’s an encouraging sign that national strategy is recognising the importance of early, local rehabilitation – but as Emily Wilson-Meredith, Clinical Specialist Physiotherapist at PSP, points out, there’s still a significant gap between policy and reality. 

A positive direction – but services are already stretched 

“It’s great to see that the government’s plan for the NHS includes a push for more community-based rehabilitation. However, there are currently huge waiting lists for these services – especially for children, young people and adults living with long-term neurological conditions” Emily explains. 

According to Nuffield Trust, almost one in four children and young people are waiting over a year for treatment. The same pressures are seen across adult community rehabilitation, where increased demand, workforce shortages and limited capacity are leading to long delays in accessing therapy. 

These waits have far-reaching effects – from delayed recovery and increased hospital admissions to the emotional toll on individuals and families waiting for help. 

“Delays to rehabilitation can cause long-term issues and prevent people from returning to work, school, or meaningful activities. Carer burnout during this waiting period is another real issue” Emily explains. 

Balancing community and inpatient rehabilitation 

While community rehabilitation is vital, Emily highlights that inpatient services continue to play an essential role – particularly for those who require consistent, intensive input following injury or illness. 

“Community rehabilitation is often limited, not only by waiting lists but by the number of sessions or weeks available. For people with complex or long-term conditions, a short block of therapy simply isn’t enough. That’s why inpatient rehabilitation still plays an essential role, offering consistency and intensity that can be difficult to achieve at home.” 

The role of independent providers 

NICE’s guidance marks an important policy shift, but the challenge now lies in ensuring the capacity and consistency to deliver it. As the NHS faces growing pressures, independent providers like PSP are well placed to help bridge the gap. 

“Private providers such as PSP are in a prime position to assist with the shortfall,” says Emily. “We can offer timely, specialist rehabilitation in both community and care settings – including services like botulinum toxin management that aren’t always available through every NHS trust.” 

Looking ahead 

For Emily and the PSP team, rehabilitation is not just about therapy sessions – it’s about giving people of all ages the tools and confidence to rebuild their lives. 

“Community rehabilitation is the right direction” Emily concludes, “but to make it truly effective, it has to be accessible, continuous and flexible enough to meet individual needs”. 

 As the healthcare landscape continues to evolve, PSP will continue to advocate for accessible, high-quality rehabilitation for every child, young person, and adult who needs it. 

Learn more about PSP’s paediatric and neurorehabilitation services: https://psp-uk.co.uk/