Page 106 - Mind, Body and Spirit 2016/17

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THE DIRECTORATE OF DEFENCE REHABILITATION FOREWORD
Maj (MAA) A Barnett RAPTC
Another year completed and another assignment done; but what a privilege it has been to work at the Directorate of Defence Rehabilitation. Without doubt one of the most demanding, frustrating but rewarding assignments of my career to date. Thank you all who I have worked with for your time and patience on dealing with a now and again irate Welshman!
The Directorate has gone through a major change over the last year; re-subordinating under Defence Primary Healthcare (DPHC) and taking the lead Clinically of Defence Rehab. The team works in two locations; DMRC Headley Court and HQ DMS, Whittington Bks, Lich eld. This obviously has its dif culties, but the team are striving to make the best of a dif cult situation for the bene t of Defence patients. In 2018, the Directorate will move with DMRC Headley Court to the new Defence National Rehabilitation Centre (DNRC) at Stanford Hall; this should ease the burden of the split site working.
The ERI has yet again come under scrutiny from the “penny pinchers” that seem to control Defence these days. Although
the Directorate is being continually bombarded for an increase in ERIs, there is simply no money to grow this sought after capability. Regardless of the lack of money, the ERI still punches well above their weight and deliver an excellent service to Defence. Well done all! However, we must not rest on our laurels and continue to close the gap between the mainstream PTI and the ERI to ensure those who are returned to a gradual and progressive PT programme do not return to the rehab process through poor management. The inclusion of the Best Practice Rehabilitation Working Group (BPRWG) and the S & C Group within HQ RAPTC aims to close this gap and provide a coherent structure that will take injured personnel through all stages of rehab and reconditioning using the principles of S & C. There will in time, be a clear line where rehab nishes and reconditioning starts with each practitioner knowing what they need to achieve to ensure our workforce are t to ght!
Finally, we welcome WO1 (SMI) Gaz Till RAPTC to the Directorate and bid a sad farewell to WO1 (SMI) Claire McIlroy RAPTC who has transitioned into civilian life. We wish Claire all the very best in her career choices and family life; you will be missed.
DEFENCE MEDICAL REHABILITATION CENTRE – HEADLEY COURT
WO2 (QMSI) M Arthur RAPTC Treatment Coordination Warrant Of cer (TCWO)
‘Working together to deliver excellence in Rehabilitation’
As this is my third and nal submission for the DMRC, it would be remiss of me not to take the opportunity to sincerely thank those who I have worked with from across the three Services. In particular, I would like to thank the ve OR7 Lead ERIs who have worked tirelessly to ensure maximum clinical output and quality which has been maintained during a period of signi cant change.
Re ecting upon the journey, I can say with utmost
certainty that it has been an absolute pleasure
to ful l the appointment and one where I have
been exposed to many different experiences and
challenges. Nothing more so than planning for a
complete transition to a new site, approximately
130 miles away in Stanford-on-Soar near Loughborough. At the time of submission, the Centre is only 55 weeks away from the receipt of keys and deployment of the advance party.
DMRC ERI team with the RSM
The Defence National Rehabilitation Centre (DNRC) was the brainchild of the 6th Duke of Westminster, the late Sir Gerald Grosvenor whose vision was to provide a state of the art treatment facility and crucially, secure Defence Rehabilitation for the foreseeable future. This will be achieved with the development of a 358 acre site in the grounds of a Grade 2 listed Georgian stately home, as the £300million pound centre will offer the very best for our patient population and in the future, potentially the civilian sector through collaboration with the national component.
As we have now fully embedded into contingency, clinical services will continue to evolve in conjunction with the requirement, however, it’s important to note
that team structures and delivery will essentially remain the same upon transfer to the new site. The DMRC will continue to offer access to a complete multi-disciplinary team which aside from ERI and physio, includes occupational therapists, social workers, mental health practitioners and senior military consultants who specialise in sports and exercise medicine. This level of service is not available anywhere else across the services and cannot be matched within the civilian sector.
Recent restructures have allowed for the clinical re-focus of the specialist team, to cater for the bio-psychosocial model which although relatively broad in view, attributes outcome to the interaction between biological, psychological and social factors. In the simplest terms, for certain cohorts, the psychological and social factors need to be addressed in a bid to resolve musculoskeletal issues or offer any chance of progression. The specialist team now offer bespoke patient admissions for some of the most complex cases in Defence.
Due to the unpredictable nature of the asymmetric threat, the maintenance of a surge capability remains at the forefront of