Continuity of Care in ABI Services: Preventing Breakdown Across Pathways
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Continuity of care is one of the most critical and fragile elements of acquired brain injury pathways. Disruptions in staffing, changes in service model or poorly managed transitions frequently lead to escalation, safeguarding incidents and loss of trust. Commissioners and inspectors increasingly expect ABI providers to demonstrate how continuity is actively protected across pathways, rather than assumed.
This article explores how ABI services can maintain continuity of care across complex pathways. It should be read alongside Service Models & Care Pathways and Safeguarding, Capacity, Risk & Vulnerability.
Why continuity matters in ABI services
People with ABI often rely on familiarity, routine and trusted relationships to manage cognition, behaviour and emotional regulation. Disruption can quickly undermine stability.
Commissioner and inspector expectations
Two expectations are consistently applied:
Expectation 1: Planned continuity. Commissioners expect providers to plan for continuity during transitions, staffing changes and service reconfiguration.
Expectation 2: Risk mitigation. Inspectors expect providers to identify continuity risks and take proactive action.
Continuity through staffing and relationships
High staff turnover or inconsistent deployment is a major risk factor in ABI services. Providers must prioritise relationship continuity.
Operational example 1: Key-worker stability
A provider introduced protected key-worker arrangements during pathway transitions, reducing incidents and anxiety.
Managing continuity during transitions
Transitions between services or accommodation are particularly high-risk for continuity breakdown.
Operational example 2: Overlapping support periods
A service implemented overlap periods where outgoing and incoming teams worked together, maintaining consistency.
Information continuity and handover quality
Continuity is not only relational but informational. Poor handovers increase risk significantly.
Operational example 3: Structured ABI handovers
A provider introduced ABI-specific handover templates, improving consistency and reducing errors.
Governance and assurance
Providers should evidence continuity management through:
- Transition risk assessments
- Staffing continuity metrics
- Incident analysis linked to disruption
Continuity as safeguarding infrastructure
In ABI services, continuity of care underpins safety, trust and outcomes. Providers that actively protect continuity demonstrate safeguarding maturity and inspection-ready governance.
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