Following the acute stage, the survivor should be offered appropriate rehabilitation according to their needs. This should be specialist interdisciplinary rehabilitation from a brain injury or neuro-rehabilitation team.
Specialised inpatient rehabilitation services in London
Some people will need specialised, intensive inpatient rehabilitation for a period before they may be ready to return to the community. Such rehabilitation is usually directed by a consultant in rehabilitation medicine. Services in London are provided by eight specialist rehabilitation units:
- The Regional Neurological Rehabilitation Unit (RNRU) at Homerton Hospital http://www.homerton.nhs.uk/our-services/services-a-z/r/rnru-(regional-neurological-rehabilitation-unit)
- The Blackheath Brain Injury Rehabilitation Centre http://huntercombe.com/our-centres/blackheath-brain-injury-rehabilitation-centre
- The Regional Rehabilitation Unit (RRU) at Northwick Park Hospital http://www.lnwh.nhs.uk/services/a-z-services/r/rehabilitation/regional-rehabilitation-unit/
- The Acute Stroke and Brain Injury Unit at the National Hospital for Neurology and Neurosurgery http://www.uclh.nhs.uk/OurServices/ServiceA-Z/Neuro/Stroke/ABIU/Pages/Home.aspx
- The Neurorehabilitation Unit at St George’s Hospital (previously the Wolfson Neurorehabilitation Unit) https://www.stgeorges.nhs.uk/service/neurology/neurorehabilitation/
- The Rehabilitation Unit at the Royal Hospital for Neuro-disability http://www.rhn.org.uk/our-work/rehabilitation/
- The Lishman Brain Injury Unit at the Maudsley Hospital http://www.national.slam.nhs.uk/services/adult-services/braininjuryunit/
- The Frank Cooksey Rehabilitation Unit at Lewisham Hospital (part of King’s College Hospital NHS Trust) http://www.kch.nhs.uk/service/a-z/frank-cooksey
These services are funded by NHS England; its Clinical Reference Group for such services has produced a reader-friendly version of the service specification
Community Neuro-rehabilitation Services In London
This is still very much a postcode lottery in terms of what is available. Information can be found in London Services here and here.
Members of the interdisciplinary rehabilitation team (both in inpatient settings and in the community)
These include:
Clinical Psychologists have specialised training in the assessment and treatment of psychological problems.
Neuropsychologists have training and experience in the area of neuropsychology, which is concerned with the relationship between brain functioning (and brain injury) and thinking, emotions and behaviour.
Occupational Therapists specialise in helping the person after a brain injury to become as independent as possible in personal care and activities of daily living, including activities within the home and local community. They also provide support with consideration of any plans for returning to work or education.
Speech and Language Therapists specialise in helping with problems with speech and/or language or communication.
Physiotherapists specialise in helping with any physical difficulties resulting from the brain injury.
Involvement of family/carers in the rehabilitation process
It is important that family/carers should be engaged wherever possible in all relevant aspects of the rehabilitation process. They should in effect be regarded as part of the rehabilitation team. To quote Carolyn Rocchio – a well-known carer and campaigner in the USA:
“How can a family be expected to understand the many ways brain injury can impair an individual without witnessing it first hand in a setting with trained personnel demonstrating strategies for reducing the impairment?
Hands-on experience is one of the few methods for families to acquire the skills they will need in the months or years to follow…….” Carolyn Rocchio. Whose Responsibility Is It Anyway? [Brain Injury Source 1999; 3(4): Brain Injury Association of America (BIAUSA)].