Neurological rehabilitation inpatient referrals

Our main focus is neurological rehabilitation; however, we do consider referrals of other non-neurological patients who require complex multidisciplinary input, such as after multiple amputation and/or polytrauma.

When considering a referral, please ensure that the patient has been appropriately investigated and been given a diagnosis that explains their impairments.

Referrals to the unit are assessed by the multidisciplinary team both on their eligibility for admission and whether the patient's needs can be safely and appropriately managed in this setting.

As a centrally funded regional level 1 Rehabilitation unit, our eligibility criteria are defined by NHS England.

We use the Patient Categorisation Tool (PCAT) to help define the complexity of patients' rehabilitation needs.

Please see the following criteria which can be used as a guide for referrers to consider when to submit a patient referral to the inpatient service.

Inclusion

Patients with Category A needs (defined on the PCAT)– i.e. primarily severe physical, cognitive, communicative disabilities, psychological adjustment support needs, behavioural change that is complex to manage, social and family support needs with highly complex rehabilitation needs that are beyond the scope of their local specialist rehabilitation services.

This can include patients in prolonged disorders of consciousness and patients who would benefit from access to a wide range of services including the following.

• Intensive, coordinated, interdisciplinary intervention usually from four or more therapy disciplines
• Specialist medical input from Rehabilitation Medicine
• Specialist rehabilitative nursing care
• Longer rehabilitation programme, typically three months
• Very high intensity input such as 1:1 nursing or two to three trained therapists at one time (for example challenging behaviour, manual handling etc.)
• Higher level facilities / equipment such as Orthotics, Augmentative and Alternative Communication (AAC), and specialist seating, subject to local commissioning

Exclusion

• Patients with less complex rehabilitation needs (as defined by the PCAT)
• Patients with behaviours that are highly complex and challenging to manage that require admission to a specialist neurobehavioural unit
• Pre-existing and active psychiatric disorders of sufficient severity to prevent progress in neurorehabilitation
• Patients who require high intensity input from neuropsychiatry and Registered Mental Health Nurse (RMN)
• Vocational rehabilitation as only or primary rehabilitation goal
• Ventilated patients or patients with tracheostomies, patients requiring daily respiratory physiotherapy interventions other than mechanical cough assist
• Patients with nasogastric tubes in certain circumstances (for example who are solely reliant on the NG for nutrition or who require frequent reinsertion (PEG/RIG is accepted): discussed on a case-by case basis
• Ongoing management of complex / unstable medical problems, requiring acute care
• Primary Functional Neurological Disorder
  

Referrals

Please use Online Acute Referral System (OARS) choosing 'rehabilitation' as the specialty to refer to. Thank you.

New referrals are considered on a weekly basis, and we will contact the referrer after the first meeting.

Potential outcomes include:

• immediate acceptance on the waiting list
• collecting further information by coming to assess the patient and/or by telephone
• transferring the referral to another service within the centre
• suggesting some other way of resolving the problem.

If you have queries or need assistance with making your OARS referral please contact us.

Email: oce.referrals@ouh.nhs.uk