Bedfordshire Neuro Rehabilitation and Early Support Discharge Stroke Service

Contact us

You can contact our service Monday to Friday 8am to 4pm.

Telephone number - 0300 790 6832
Email address - ccs.beds.adults.neuroesd@nhs.net
Referral information
Referral email address - ccs.bedsneuro.referrals@nhs.net

Welcome to our service

Our services help people who have long term neurological conditions, or strokes who require a specialist rehabilitation program in a community setting.

Working as one team allows us to be flexible in our continuity of care for stroke survivors between early supported discharge service and neurological rehabilitation teams.

Neurological rehabilitation or neuro-rehab team (NRT)

NRT provide a specialist rehabilitation program in a community setting. This helps patients who have long-term neurological conditions or strokes.

Stroke early supported discharge (ESD) service

ESD provide up to 6 weeks rehabilitation. That's similar to what is in the hospital. This helps patients admitted to acute stroke units to be discharged sooner.

We are a multi disciplinary team (MDT). We have physiotherapists, occupational therapists, speech and language therapists, psychologists, and assistant practitioners, who are specialists in neurological.

Bedfordshire stroke 6 month review

As part of ongoing service development and in line with Early Stroke Discharge services across Luton and Milton Keynes.

The locally agreed model provides a comprehensive review by a stroke review coordinator within 4 to 8 months of stroke to assess progress and identify any unmet needs across recognised health, psychological, leisure, social and work domains. Choice of telephone or face to face session (home or clinic environment) is given to support varying mobility requirements, transport and communication or cognitive difficulties.

6 month post stroke reviews provide background to compare new or ongoing environmental, physical or psychological difficulties that may arise.
Providing consistency and continuity to the patient and carer.
Specialist knowledge and experience of reviewer working within local stroke pathway with ability to provide further reviews as appropriate to patient and carer needs.
Impact to reduce risk of readmission to hospital and referral to other services through immediate action on issues identified.
Stroke review coordinator has strong interdisciplinary approach within the neuro therapy services in Bedfordshire to support the stroke survivor within the community.
Address secondary stroke prevention, stroke recovery and disability management as part of the review.

Referrals

We will accept referrals from:

patients (self-referral)
all professionals

To make a referral call 0300 790 6832 or email ccs.bedsneuro.referrals@nhs.net

Neuro rehabilitation team (NRT) eligibility criteria

We provide support to adults who:

are aged 18 years old and older who are registered with a Bedfordshire GP
are medically stable
newly diagnosed with a long-term neurological condition or following a deterioration in their existing neurological condition who will benefit from multidisciplinary therapy and are able to make functional gain with the intervention
are able to make consistent progress
are able to participate in the rehabilitation
understand the concept of rehabilitation and is able to work towards a goal

Early support discharge (ESD) service eligibility criteria