Department of Health

Website of the Department of Health

Please note that this website has a UK government access keys system.

NHS logo

Quality requirement 4: Early and specialist rehabilitation

*An asterisk in an example indicates that its approach could be adapted for other long-term conditions.

Quality requirement 4

People with long-term neurological conditions who would benefit from rehabilitation are to receive timely, ongoing, high quality rehabilitation services in hospital or other specialist settings to meet their continuing and changing needs. When ready, they receive the help they need to return home for ongoing community rehabilitation and support ('home' in this context means the place where the individual chooses to live, which may be their own accommodation or may be a residential or care home).

Brain Injury Assessment and Rehabilitation Service, Royal Hospital for Neuro-disability

The Brain Injury Assessment and Rehabilitation Service is a national inpatient service specialising in assessment, disability management and rehabilitation for adults with severe to profound acquired neurological impairment, presenting with complex neuro-disability. The multi-disciplinary team specialises in assessing, treating and managing complex neuro-disability using a goal-orientated approach. Tools/protocols developed by the service include SMART and PASWORD.

Brain Injury Rehabilitation Trust, Milton Keynes

The Brain Injury Rehabilitation Trust at Thomas Edward Mitton House in Milton Keynes is a 16-bed rehabilitation unit for adults with acquired brain injury.

The Eastern Head Injury Group Study, Addenbrooke's Hospital, Cambridge

The Eastern Head Injury Group Study (EHIS) was set up in 2000 to assess the current provision of HI services in the Eastern Region, and to facilitate strategic planning and development of high quality acute and rehabilitation services in line with national guidance. They have developed a number of useful resources including Head Injury Standards for Acute Hospitals, a set of rehabilitation codes which map patient pathways through the rehabilitation stages, and a template for HI coordination.

Neuro-behavioural Rehabilitation Unit (NRU), Royal Hospital for Neuro-disability

The Neuro-behavioural Rehabilitation Unit (NRU) is a national inpatient service specialising in assessment, rehabilitation and long-term disability management of adults with neuro-disability and challenging behaviour. The Unit follows a philosophy of 24-hour behaviour management using 'positive programming' i.e. aversive strategies such as time out or response cost are not used. Proactive strategies include environmental management, positive programming and focused behavioural support. The Unit has developed a variety of approaches and tools which it is willing to share.

Rakehead Rehabilitation Centre, Burnley

The Rakehead Rehabilitation Centre is an accredited practice development unit which delivers comprehensive rehabilitation.

Redford Court, Liverpool

Redford Court is a purpose-built residential rehabilitation service for adults with acquired brain injury. It provides highly individualised support for people with an acquired brain injury, including opportunities for vocational rehabilitation through college and work placements.

Regional Rehabilitation Unit (RRU), Northwick Park Hospital, Harrow, London

This is a specialist rehabilitation service for younger adults with severe complex neurological disabilities, which offers both specialist inpatient rehabilitation and an outreach service. It forms the hub of a closely interlinked network of specialist rehabilitation services within the North West Thames region.

Stroke Services, Worcester Royal Hospital

The stroke bed-scheme is led by a Stroke Specialist Nurse who coordinates in-patient care for medically stable stroke patients who require a high level of nursing and therapeutic input from the multi-professional team. A weekly Relatives Clinic is held which gives the stroke team detailed key information, often from the onset of the stroke, on which to base discharge plans and to inform other decisions. It is a forum for sharing information on patients’ progress and signposting relatives to support networks and services.

Transitional Living Unit (TLU), Haberdasher's House, Royal Hospital for Neuro-disability, London

The Unit was established in 1993 to help adults with acquired brain injury return to the community and live as independently as possible. Using a goal-orientated approach, it works with residents who have differing physical, cognitive, behavioural and functional abilities, to achieve the aims that they identify. The Unit has produced a report highlighting best practice in approaches to joint working between social services and health authorities in the area of supported independent living units, which has involved representatives from Health Authorities, Social Services Departments, Care Agencies and Housing Departments.

*West Midlands Rehabilitation Service

The service provides link workers for people from ethnic minority groups undergoing neurological rehabilitation. The link workers receive additional training about brain injury rehabilitation. They have helped individuals and their carers to have a better understanding of the rehabilitation process and to make individuals' rehabilitation more culturally appropriate.

Additional links

Overview of the examples

How the examples were chosen and evaluated, and how to submit an example.

Access keys