Right place, right skills

1.Unlock the potential of rehabilitation services in prevention and self-management

Rehabilitation must be central to prevention and self-management, not added after a crisis. Physiotherapists and rehabilitation teams help people stay active, manage symptoms, avoid deterioration and recover confidence. In neighbourhood services this means earlier access to expert assessment, personalised advice, supported self-management and timely onward referral. It also means making rehabilitation visible in population health planning, so people with long-term conditions, frailty, pain, cancer, respiratory disease or mobility loss can get help before needs escalate. 

Services should be easy to reach, culturally appropriate and connected to voluntary, community and social care support. Unlocking rehabilitation’s potential will reduce avoidable demand on hospitals and general practice, while helping people live independently for longer. It is a prevention offer, a recovery offer and a route to better lives. And it’s needed in every neighbourhood, now.

2. Create a reinvestment cycle for recovery 

Neighbourhood health needs a funding flow that rewards recovery, not just activity in hospitals. When effective rehabilitation prevents admissions, shortens stays or reduces care needs, the savings should be reinvested into the community rehabilitation that generates them. This creates a cycle where better recovery funds further transformation. Without this, community teams are asked to absorb more demand without the staffing, space or leadership needed to change services safely. 

Commissioners should track the impact of rehabilitation on acute activity, social care use, work, independence and quality of life, then use that evidence to build sustainable services. A reinvestment cycle makes the shift from hospital to community practical, measurable, fair and capable of lasting long term everywhere, for everyone.

3. Invest to transform community health services as part of neighbourhoods

Moving care closer to home will not succeed if community services remain under-resourced. Neighbourhood teams need enough rehabilitation staff, clinical space, equipment, digital tools and leadership time to deliver proactive, joined-up support. Investment should enable new models of care, not simply move hospital waiting lists into community settings. 

This means strengthening multidisciplinary teams, developing advanced and consultant practice, and supporting collaboration with primary care, social care, housing, leisure and voluntary sector partners. 

Transformation must be clinically led, locally designed and backed by national expectations so people can access high-quality rehabilitation wherever they live, at every stage of recovery.

4. Measure what matters to people: function, recovery and independence

Neighbourhood health should measure outcomes that matter to people, not just contacts, waits or discharge rates. For rehabilitation, that means function, confidence, mobility, participation, independence, return to work and ability to live well with symptoms or long-term conditions. These measures show whether services are helping people recover, prevent deterioration and reduce reliance on urgent or institutional care. They also make the value of physiotherapy and rehabilitation visible to commissioners, system leaders and the public. National datasets should include rehabilitation outcomes, patient-reported measures and workforce capacity, while allowing local teams to capture what matters in their communities. Quality of life is what’s important to people – and measures should reflect that.

5. Design in rehabilitation and leadership capabilities from the start

Neighbourhoods need expert rehabilitation leadership embedded from the start. Advanced and consultant physiotherapists can assess complexity, manage risk, diagnose, triage and direct people to the right support, while also leading teams, shaping pathways, developing support workers and connecting clinical care with community assets. 

These roles must be funded, governed and recognised so rehabilitation is not an afterthought. Building this capability in from the start will help neighbourhood services operate safely, prevent avoidable harm, support independence and make best use of every professional’s skill. 

• Surrey Downs closed a 35-bed acute ward and released £2m of acute savings, with reinvestment into community services.
• Dorset’s integrated stroke model reduced readmissions by 75%, showing the impact of joined-up rehabilitation closer to home.
• Leeds Home First is linked to 869 fewer admissions a year, with estimated savings of £24.3m.