NSW Government

Designing State-wide Rehabilitation Services for Neurological Injury

The Challenge

The Australian New South Wales Lifetime Care and Support Authority (LTCSA) through the Lifetime Care and Support Scheme (LTCSS) provides treatment, rehabilitation and attendant care services to severely injured people in motor accidents in NSW, regardless of who is at fault in causing the accident.

LTCSA engaged Ernst & Young and J Bara to describe current services and funding arrangements from retrieval and pre-hospital care through to community reintegration. National and international practice was reviewed to inform recommendations on how to improve the delivery of improved services for catastrophic neurological injury in NSW.

People eligible for the Scheme will have suffered a spinal cord injury, moderate to severe brain injury, multiple amputations, severe burns, or will be blind as a result of the accident. The majority of the participants to the scheme have catastrophic neurological injury (ie. Severe spinal cord or brain injury).

The Solution

Guiding Principles

The project was been guided by seven key principles. These principles represent a balanced set of values for understanding the effectiveness of the current system and the recommended model of care. The guiding principles are shown below.

1. Safety
2. Consumer Participation & Centredness
3. Appropriateness
4. Equitable Access
5. Effectiveness
6. Efficiency
7. Outcome Focused

Recommendations – Delivering Improved Outcomes


There are four areas that will lead to improved outcomes for people with catastrophic neurological injury. Evidence or strong prevailing opinions exist to support these views.

• Develop, specialise and concentrate SCI and TBI skills and services.
• Improve lifetime outcomes by earlier intervention during pre-hospital, acute and rehabilitation stages of care, and/or broaden the focus of care during these earlier stages.
• Develop and deploy model addressing jurisdictional challenges and opportunities for delivering improved lifetime outcomes.
• Develop data and information for supporting these models

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