Stockton JSNA

Physical disabilities

What evidence is there for effective intervention?

National Institute for Health and Clinical Excellence (NICE)

Active for life: Promoting physical activity with people with disabilities (guidelines)

Multiple sclerosis: Management of multiple sclerosis in primary and secondary care (CG8)

Osteoarthritis: The care and management of osteoarthritis in adults (CG59)

Rehabilitation after critical illness (CG83)

Depression in adults with a chronic physical health problem: Treatment and management (CG91)

Spasticity in children and young people with non-progressive brain disorders: Management of spasticity and co-existing motor disorders and their early musculoskeletal complications (CG145)

Osteoporosis: assessing the risk of fragility fracture (CG146)


The IBSEN project - National evaluation of the Individual Budgets Pilot Projects

The National evaluation of the Individual Budget pilots notes that -
“(younger physically disabled people) were significantly more likely to report higher quality of care (having taken up an Individual Budget), and were more satisfied with the help they received. The choice and control afforded by an Individual Budget has apparently given them the opportunity to build better quality support networks”.

The Care Services Efficiency Delivery (CSED) guidance addresses issues of enablement / inclusion for a number of client groups including those with physical impairment.   This service has been co-designed with health organisations and begins at the stage when they require community care assessments for care packages.  The aim is to have intensive periods of reablement and assessment (6-8 weeks) to enable people to gain confidence in independent living skills prior to having independent care providers carry out these tasks.  It is hoped that through this mechanism people will have tailor-made care packages which will be specific to their needs.

Raising Expectations and Increasing Support (DWP, 2008) announced the government’s intention to introduce legislation to give disabled people the right to control certain public funds spent on their support.

National Service Framework (NSF) for Long Term Conditions (DH, 2005a) aims to transform the way health and social care services support people with long-term neurological conditions to live as independently as possible. It puts the people who have these conditions, along with their family and carers, at the centre of care by setting evidence-based quality requirements from diagnosis to end of life care.  Although the NSF is focused on people with long-term neurological conditions, the principles enshrined in the framework apply to all people with a physical disability.

Independence, Well-being and Choice (DH, 2005c) offers a vision for the future of social care for adults in England. Person-centred, proactive and seamless services are promoted so that people who use social care services will have more control, more choice, and the chance to do things that other people take for granted.

Our Health, Our Care, Our Say (DH, 2006) set the Government’s vision for health and social care services.  It is underpinned by achieving four main goals:

  • better prevention and early intervention for improved health, independence and well-being;
  • more choice and a stronger voice for local individuals and communities;
  • tackling inequalities and access to services;
  • more support for people with long-term needs.


Putting People First (DH, 2007) is a ministerial concordat establishing a shared vision and commitment across Government. It sets out the shared aims and values, which will guide the transformation of adult social care.

Improving the Life Chances of Disabled People (DH, 2005b) is a cross-government policy. The vision is for disabled people in Britain to be respected as members of society by 2025.

Disabled People's User-led organisations - organisations led and controlled by the users, are a vital part of the new approach which supports independent living.


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