Adult Community Rehabilitation Team Rachael Cottier Neuro Physio

Adult Community Rehabilitation Team Rachael Cottier Neuro Physio Team Lead (020 7683 4489)

ACRT • Specialist assessments and therapy for adults (over 18 years old) with neurological and physical conditions • Provide high quality care • Client-centred • Goal orientated service • Community and out-patient service

Structure of the team • The team has two specialities: • Neurological Conditions (progressive and non-progressive) – E. g. Stroke, MND, MS, PD, GBS, SCI • Physical Conditions – E. g. OA, RA, amputee’s, DM, fallers, COPD

Multi-disciplinary team • Large MDT including: – – – – • Physiotherapists Occupational Therapists Speech and Language Therapists Clinical Neuro Psychologists and Psychologists Rehabilitation Assistants AHP Consultant (Neuro navigator) Consultant Neurologist (internal referral only) Admin support We also work as in interdisciplinary team

Referral to the team • Telephone referral – Ring the screening line on 020 7683 4148/4499 – Lines open between 10 am and 4 pm • Out of hours referral – – Complete referral form and email/fax/post to the team huh-tr. outofhourscommunitytherapy@nhs. net Fax: 020 7014 7260 Post: ACRT, 2 nd Floor, D Block, St Leonard’s, Nuttall Street, London, N 1 5 LZ • Self-referral – We accept referrals from client’s if they have previously been known to the team

Essential referral details • • • Client demographics Reason for referral Goals Main condition Past medical history Current social situation e. g. package of care Functional Ability Risk Assessment Any other services involved Ø Referral will not be accepted if all of the information is not present

Neuro-specific services available • • • Vestibular assessment and rehabilitation Functional Electrical Stimulation (FES) assessment Saeboflex Lycra garment assessments Orthotics and splinting provision Cognitive assessment and rehab/strategies Fatigue management Return to work support Dysphagia assessment and treatment Communication management LSVT LOUD

MDT PD Clinic • • • Consultant Geriatrician - Dr Singhai PD CNS - Sandra Glynn Bryning Unit Nursing Staff ACRT – Physio, OT and SLT Neuro Psychology (ACRT)

PD Pathway (Diagnostic Phase) Referral Consultant appointment MDM ACRT clinic Nursing Assessment Onward Referrals

ACRT Parkinson’s disease Clinic • • • ACRT provide an in-reach service Referrals –via PD Clinic MDM New clients and review clients Interdisciplinary model PD-specific assessment

ACRT PD Clinic • Assessment identifies if the client requires referral to: – ACRT intervention – Social Services – Other services e. g. Foot Health, DN – Psychology support – PD exercise group – PD education group • Feedback to PD team in MDM

Clinical Neuropsychology • (1) Diagnostic pathway – Referrals can be made by Consultant Geriatricians to Diagnostic Neuropsychology to support early differential diagnosis of PD and PD+ syndromes • (2) Rehabilitation – ACRT psychology: integrated, MDT support, 1: 1 patients, cognitive assessment and yearly reviews, family education, Capacity assessment, training

PD education group • Newly diagnosed clients (or not > 3 years) with/without mild PD symptoms • Open to family members and carers • Education to aid self-management • Supportive forum • Topics cover wide range of symptoms • Highlights community service available

PD education group contents 6 sessions running over 2 half days: 1. 2. 3. 4. 5. 6. Signs and symptoms + emerging treatments (Dr Singhai) Keeping healthy through nutrition and exercise (Physio) Speaking and swallowing (SLT) Functioning well (OT) Emotional wellbeing (Neuro Psychologist) Services in City and Hackney (St Joseph’s Hospice)

PD exercise group • High-level exercise group • Early to mid-phase PD (1 -2. 5 on Hoehn and Yahr Scale) • Resident of City and Hackney • Based on up-to-date evidence • Neuro-protective influence of exercise • Jointly with Healthwise team • Automatic referral to the Healthwise scheme • Location – Britannia Leisure Centre • Duration – 8 weeks • Coincides with PD education group

Contents of the group • • • Warm-up and cool down Cardiovascular training Strength training Large-amplitude exercises (BIG) Balance work Movement initiation strategies Agility practice Flexibility exercises Practice of getting on and off the floor Relaxation Stretches

UK Parkinson’s Excellence Network • Hosted by Parkinson’s UK • Bringing together health and social care professionals for care transformation • Enables joint working • Building an expert workforce • Equipping professionals to influence services • Strengthening voice of people with PD (Parkinson’s UK website)

Summary • ACRT provides community and out-patient rehabilitation for adults with neurological and physical conditions, focusing on client-centred goals • ACRT provides an in-reach service for the PD clinic at the Bryning Unit, contributing to the PD MDT service at Homerton Hospital • People with PD can be offered 1: 1 ACRT therapy for rehabilitation or signposted to relevant services • An education and exercise group is available for newly diagnosed (and minimal symptoms) people with PD