Mind the gap: rethinking community neurological rehabilitation services

Recognition that there was a lack of knowledge about what services existed for adults aged 18–65 years with an acquired neurological condition in North Cumbria, and how they were accessed and co-ordinated, led to a project to identify community rehabilitation provision and explore potential service models. Interviews were undertaken with service providers, and focus groups, interviews and a questionnaire were undertaken with services users and carers. The five areas of concern to emerge from a thematic analysis of the data related to service provision; respite care and day time occupation, transport and geography, co-ordination of services, and information. There were differences in perspectives and priorities. Having one point of contact for access to all services emerged as the preferred model, although this would not address the gaps in service provision. Despite the recognition that the National Service Framework for Long-term Conditions (Department of Health (DH), 2005b) has promoted service development for the target group, there is still a need to work towards greater coherence in service provision across a plurality of providers.