The therapy team at the National Hospital for Neurology and Neurosurgery (NHNN) have established a new private outpatient service based at the Queen Square Private Consulting Rooms. This new service, which will roll out fully over the next few months, already offers specialist outpatient physiotherapy, and will soon also offer occupational therapy and speech and language therapy, bringing together a unique multidisciplinary team. This month, we sat down with Emma (a highly specialist physiotherapist), Aisling (an Occupational Therapist) and Jayne (Speech and Language Therapist) to find out more about the private therapy service in Queen Square and what they can offer.
Can we begin by asking about your role here in Queen Square, and your particular area of expertise?
Emma: I work as a Highly Specialist Physiotherapist within the inpatient and outpatient private patient service here at the NHNN. I have extensive experience in rehabilitation for a wide range of neurosurgical and neurological conditions, and a current particular interest in vestibular rehabilitation.
Aisling: As a highly specialist occupational therapist in neurology, my role is to support people with neurological impairments to do daily activities that are important to them. My particular interest and expertise lies in activity analysis, upper limb rehabilitation and cognitive rehabilitation.
Jayne: As a Highly Specialist Speech and Language Therapist, I assess and manage people who have neurological/neurosurgical communication and swallowing problems. I have a particular interest in people who have acquired problems with their language (aphasia) but also have many years’ experience in managing people who have neurogenic problems with eating and drinking.
How does the specific type of therapy you offer for neurological conditions differ from therapy for other illnesses? What techniques do you use for your patients?
Emma: Physiotherapy for neurological conditions is a speciality within the profession, requiring specific postgraduate training. I have trained in the Bobath method and incorporate some of these principles into my assessment and treatment methods alongside exercise prescription and use of equipment and adjuncts when appropriate. I always adopt a holistic approach to treatment, taking the life roles, commitments and likes and dislikes of the patient into account.
Aisling: I agree with Emma, postgraduate training and years of experience working in the field of neurology have been extremely valuable in my current role at the NHNN. My techniques focus more on activity analysis. I address the impact of physical, cognitive and emotional changes on one’s functional ability. Techniques I use may include cognitive rehabilitation, splinting, recommendation of equipment, fatigue management, or adaptive strategies.
Jayne: To work in Queen Square, you need postgraduate training in neurology, particularly with regard to how different neurological conditions require different management approaches. I use models of language processing to understand how speech and language are affected by brain injury and neurological disorders. I also commonly use specialised instrumental assessments of swallowing function such as videofluoroscopy and FEES. Treatment involves a range of highly-selective and patient-specific interventions which aim to maximise communication potential and optimise swallowing function.
What are the most common reasons for patients having therapy with you? Why is it so important that they can access specialist therapy?
The most common reason that patients seek our input is where neurological impairment is limiting their ability to live their life as they would want. With a multitude of neurological conditions often requiring different approaches to treatment it is essential that patients are seen by specialist therapists, such as our team here at Queen Square. Accessing specialist therapy can help guide the process of rehabilitation and disability management. However, patients often fall through the gap when they are discharged from hospital and miss out on valuable therapy input. This is one of the reasons we are so pleased to be able to expand our service to include multidisciplinary outpatient input.
What can a patient expect in a typical appointment with you?
An initial appointment with any of us will start with a detailed discussion of the patient’s condition and their presenting difficulties, followed by comprehensive discipline specific assessment. We all adopt a goal-orientated rehabilitation approach by working with patients to develop goals meaningful to them, and a treatment plan which suits their needs and lifestyle.
How much do you collaborate with each other and with colleagues from other disciplines? How does the patient benefit from this?
Patients frequently benefit from multi-disciplinary input in neuro-rehab, to address the different functional implications of their neurological condition. We work very closely together, referring to each other regularly and sometimes carrying out joint sessions where appropriate. Our cohesive method of working both within the team, and with other specialists in Queen Square, ensures that patients are always offered the opportunity to access any specialist services they may benefit from.
Does working in Queen Square bring any additional benefit to you and your patients?
Queen Square is well recognised as a centre of excellence in neurology and neurosurgery and we are able to provide highly specialist therapy input, supported by leading figures in the field of therapy and rehabilitation. The Queen Square therapy team have a strong ethos of continually improving our service and aim to deliver consistently excellent therapy to our patients.
How are patients able to access your services? Do they need to be referred by a specialist?
If you are accessing our service via an insurance company, the referral should be made by your NHNN Consultant. If you are self-funding your treatment, we are also able to accept self-referrals or referral via your GP.