How we are funded
The work of the Oxford Centre for Enablement is primarily funded by the NHS. The centre also accepts and will assess and manage patients who are funded commercially through other routes such as:
- medicolegal settlements
- private insurance
- health systems from other countries
- self-funding (where an individual pays from their own resources)
For more on our range of commercially available services, see private patients.
The National Health Service currently commissions (buys) services in a variety of ways. For rehabilitation, some services are purchased through specialist commissioning arrangements which are national for England and Wales, whereas most of the remainder are commissioned by local Clinical Commissioning Groups.
There is no consistent means of commissioning rehabilitation and from the perspective of the patient it is a piecemeal arrangement. For example:
- therapy services within most hospitals are not commissioned as rehabilitation
- occupational therapy within the community is funded by social services and does not provide rehabilitation therapy
- some equipment is funded through health
- other equipment is funded through social services
- long-term support may be funded through health, social services or not at all.
It is extremely rare that all of the services needed or used by an individual patient will come from one funding stream or indeed through one organisation.
Specialist commissioning pays for the first six months of specialist rehabilitation for patients with severe and complex problems sufficient to warrant rehabilitation in a "level I specialist rehabilitation centre". It must be noted that it is not the patient with the need that is funded, but the place in the centre and if a patient with these needs is not seen within a designated level I centre but is managed elsewhere then the funding does not come from specialist rehabilitation.
The patient's need for level I specialist neurological rehabilitation is determined using an agreed form which needs to be completed by a consultant in rehabilitation medicine.
Specialist commissioning also pays for prosthetic services, and complex equipment. There are separate criteria relating to this. If a patient's needs fall within the criteria, then it is funded directly on a national basis.
Clinical Commissioning Groups
All other inpatient and outpatient rehabilitation is funded by the patient's Clinical Commissioning Group, which is determined by the general practitioner that they are registered with. We have contracts with some local groups. For other patients we would need to get permission. This is usually not a problem for an outpatient assessment visit, but can be more difficult if inpatient treatment is needed.