University Hospitals Birmingham NHS Foundation Trust

Improving care for adults with peripheral nerve injury in the West Midlands

Peripheral nerve injury, often caused by trauma, commonly affects the arm. Around 10,000 people in the UK experience an upper limb peripheral nerve injury each year. Many do not fully recover and live with long-term effects such as paralysis, loss of sensation, chronic pain, and psychological distress. These injuries often affect young men from low socioeconomic backgrounds working in manual labour.

A 2017 literature review found that over 90 percent of adults with peripheral nerve injury experienced post-traumatic stress syndrome, though based on a small number of studies mostly outside the UK. Patient interviews in 2023 further highlighted the psychological impact. During consensus workshops, patients reported inadequate access to both physical and psychological rehabilitation.

NICE guideline NG211 recommends physiotherapy and psychological support. The James Lind Alliance has identified psychological treatments for brachial plexus injury as a top priority. However, there is a mismatch between NHS capacity, patient needs, and national recommendations. Clinicians often recognise psychological distress but lack the training to address it.

This study aims to identify how many adults with peripheral nerve injury, including brachial plexus injury, experience psychological impacts and require ongoing interventions. It will also explore patient demographics to inform the development of a digital intervention that supports both physical and psychological rehabilitation.

The study will help us understand the psychological consequences patients experience after peripheral nerve injury and the impact on NHS rehabilitation services.

Patient: We will better understand the demographics and unmet needs of this population, helping identify adults at risk of psychological consequences after severe nerve injury. Early targeting can address their needs. It will identify the current rehabilitation impact and help design services, physical or digital, to meet the need.

National guidance: NICE guideline NG211 recommends psychological and physical therapy. We must report compliance. Understanding if adults are accessing rehabilitation across the West Midlands will help centres report how many receive psychological support, which we currently cannot do.

Digital app development: Our PPIE group supports a mobile app offering early rehabilitation and psychological support. Adults with nerve injuries struggle to access services. This project will identify the burden on patients and NHS services, supporting co-production of digital tools to reduce this burden.

We have contacted NHS approved app GetUbetter and aim to partner for NIHR funding in November 2025 to co-develop and test psychologically informed digital rehabilitation. This would supplement, not replace, face to face care.

The project’s findings will justify the innovation and funding. Early identification and co-design of digital rehabilitation could reduce disability and the social and economic burden of nerve injuries.

01/04/2025

SDE105

West Midlands SDE trusted research environment

Not yet published.