What does NICE say about brain injury rehabilitation?

In October 2025, NICE published guideline NG252: Rehabilitation for chronic neurological disorders including acquired brain injury. It is the first national guideline of its kind to cover rehabilitation for people with acquired brain injury across all settings and all stages of recovery.

For solicitors working on brain injury cases, it sets a new benchmark. For families, it sets out what good rehabilitation looks like and what they should expect. For case managers, it describes an approach that reflects established good practice.

Who the guideline covers

NG252 applies to children, young people, and adults with acquired brain injury, including traumatic brain injury, hypoxic brain injury, and other acquired conditions. It covers rehabilitation in hospital, in the community, and at home.

It does not cover stroke rehabilitation in adults, or rehabilitation for cerebral palsy, dementia, or epilepsy.

Holistic assessment from the start

One of the central recommendations is that rehabilitation needs should be identified as early as possible and assessed holistically. NICE recommends that holistic rehabilitation needs assessment should consider physical health, cognitive function, mental health, social circumstances, communication, and the person’s ability to take part in daily life.

This is what a well-conducted Immediate Needs Assessment sets out to do. Our Immediate Needs Assessments are built around the WHO ICF framework, which maps directly onto the domains NICE recommends covering.

The guideline is also clear that assessment should not be delayed, and that rehabilitation should not wait for assessment to be complete.

Coordinating the right team

NG252 recommends that one professional should take the lead on holistic needs assessment and rehabilitation planning. That person is responsible for identifying and coordinating the health, mental health, and social care practitioners who need to be involved, and for making referrals where other needs are identified.

This is the case manager’s role. A case manager does not provide therapy directly. They assess, plan, commission, and coordinate. They keep the rehabilitation plan current as the person’s needs change. What a brain injury case manager does explains how that works in practice.

Goal setting

NICE places considerable weight on person-centred goal setting. The guideline recommends that goals should be agreed collaboratively with the client and should focus on what matters most to them: not just physical recovery, but participation in daily life, relationships, work, and education. Goals should be broken into short-term steps, reviewed regularly, and adjusted when circumstances change.

For children, the guideline sets out specific requirements: goals should take account of developmental stage, be reviewed at key milestones, and should address education as well as health and social functioning.

What the guideline means for solicitors

NICE guidelines are not legally binding, but they carry weight in expert evidence and in court. A rehabilitation plan that reflects NG252 recommendations, holistic assessment, coordinated multidisciplinary input, regularly reviewed goals, and attention to participation as well as function, is defensible as appropriate care. One that falls short of those standards is harder to defend.

For solicitors instructing case managers, the guideline provides a useful reference point. Is the assessment genuinely holistic? Does the plan address cognitive and psychological needs as well as physical ones? Is goal setting collaborative and regularly reviewed?

What it means for families

The guideline is also written with families in mind. It recommends that families and carers are involved in assessment and goal setting where the person agrees. It recognises that invisible symptoms, such as cognitive difficulties, fatigue, and emotional changes, need to be properly assessed and not dismissed. And it sets out that rehabilitation should address participation in daily life, not just clinical improvement.

Our approach

The way we work at Hawkley Rehab reflects what NG252 recommends. We carry out holistic assessments using the WHO ICF framework. We take the lead on coordinating the rehabilitation team. We set person-centred goals with the client and review them regularly. In paediatric cases, Louise brings specialist expertise in childhood acquired brain injury that is directly relevant to the developmental trajectory NG252 describes.

You can read more about how we work and our paediatric case management.

If you would like to discuss a referral or find out what an assessment might involve, please get in touch.