The Inequalities in Health Alliance (IHA) is a coalition of more than 250 organisations, convened by the Royal College of Physicians (RCP), which campaigns for a cross-government strategy to reduce health inequalities. This blog post by Natasha Owusu, policy lead for England at the Chartered Society of Physiotherapy (CSP), is part of a series by IHA member organisations.
Poor access to rehabilitation for people with long-term conditions is driving the gap in healthy life expectancy.
For many, rehabilitation services remain out of reach, leading to disparities in health outcomes. Marginalisation, discrimination and income inequality have deepened these divides, particularly along the lines of ethnicity, gender, sexuality, and disability.
The CSP leads the Community Rehabilitation Alliance (CRA) – a coalition of over 60 charities and professional bodies across health and social care. We call for universal access to rehabilitation to close the gap in life expectancy and quality of life.
As more people live with multiple long-term conditions (LTCs), access to rehabilitation becomes crucial. Currently 43% of people are managing an LTC in the UK and 13.4 million people in England have at least two LTCs. By 2035, two-thirds of adults aged 65 years and older will have two or more long-term conditions.
People from poorer communities are 60% more likely to be diagnosed with LTCs than those in wealthier areas. Rehabilitation doesn’t just help people survive – it enables them to live well, stay active, and enjoy a better quality of life.
The CSP’s updated Rehabilitation, recovery and reducing health inequity report raises awareness of health inequities in rehabilitation services, and includes new recommendations and innovative approaches across the UK.
Millions missing out on rehabilitation services
Millions of people, especially those facing systemic discrimination or poverty, are missing vital rehabilitation services. Without access, they struggle to manage their LTCs and risk declining health.
Chronic respiratory conditions are a major cause of health inequality. Rehabilitation for chronic obstructive pulmonary disease (COPD) improves quality of life, reduces hospital admissions and shortens stays. Yet COPD patients often don’t receive adequate referrals or access to services. This highlights the broader issue of underfunded, fragmented rehabilitation services across the healthcare system.
Over the years, rehabilitation has been treated as an afterthought, not a core component of healthcare.
Promising examples
Some services are making a difference. The Hope integrated Falls and Pulmonary Rehabilitation Service in Grimsby works with former patients and carers as ‘buddies’ to guide others through rehabilitation. This has led to higher take-up, completion rates, and fewer hospital admissions.
The Community MSK Better Health Day on the Isle of Wight provided timely support for musculoskeletal conditions in a local community centre to ensure that those waiting for appointments are seen and supported.
A call to action
As IHA members, we must push for lasting change. We’ve long advocated for a cross-government strategy to reduce health inequalities, and the recent commitment to establish a Mission Delivery Board (MDB).
This is a great opportunity for the government in the NHS 10-year plan to mobilise systems to improve rehabilitation access and address health inequality. This must include NHS policies on community rehabilitation – such as the intermediate care framework; national improvement programmes for respiratory, stroke, and cardiac rehabilitation; and pelvic health physiotherapy through women’s health hubs. Implementation requires expanding the rehabilitation workforce in the next NHS Long Term Workforce Plan.
Now is the time to act. Everyone deserves the right to rehabilitation, when and where they need it.
This piece is part of a series of guest blog posts by members of the Inequalities in Health Alliance.
Natasha Owusu
Policy lead for England at the Chartered Society of Physiotherapy
