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:
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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 10am and 4pm
• Out of hours referral
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Complete referral form and email/fax/post to the team
[email protected]
Fax: 020 7014 7260
Post: ACRT, 2nd Floor, D Block, St Leonard’s, Nuttall Street,
London, N1 5LZ
• Self-referral
– We accept referrals from client’s if they have previously been
known to the team
Essential referral details
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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
 Referral will not be accepted if all of the information is not
present
Neuro-specific services available
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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
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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
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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:
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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
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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