Neuro Rehabilitation Department

Neurosciences in NHS Grampian

Neuro Rehabilitation

What kind of patients are admitted to the Neuro Rehabilitation Unit?
  • NRU is a 13 bedded rehabilitation unit based at Woodend Hospital, serving the population of Grampian which is made up of Aberdeen, Aberdeenshire and Moray. Patients are also occasionally admitted from Orkney and Shetland.
  • Most patients who are admitted have a neurological disorder, such as an acquired brain injury or spinal injury, or deteriorating chronic neurological disorder such as multiple sclerosis. Very occasionally other rehabilitation patients can be accommodated. This can be considered on an individual basis. In general, patients who require complex multidisciplinary inpatient neuro-rehabilitation are given higher priority, as they cannot access this anywhere else in Grampian.
  • Patients are aged 16-65, although patients who are younger or older are very occasionally accepted, after discussion with a consultant.
Who are the team behind the Neuro Rehabilitation Unit?
  • A team of nursing staff led by one senior charge nurse
  • There are 3 physiotherapists - 2 who job share and 1 full time
  • We have 2 Occupational Therapists at the moment
  • There is 1 Part - time Speech and Language Therapist
  • There is access to a Neuropsychologists if required but is not based at Woodend
  • We have a Nurse Practitioner who deals specifically with Posture and Movement
  • There are 3 Consultants - Dr Gooday, Dr Akporehwe and Dr Purkayastha
Who should be referred?

Patients should be referred if:

  • They have identified rehabilitation goals
  • They require or are likely to benefit from multidisciplinary inpatient neuro-rehabilitation. Specific issues which may need to be addressed include spasticity management, posture and seating, cognitive assessment, speech and swallowing difficulties and bowel and bladder problems which cannot be dealt with in the community
  • They require multidisciplinary assessment, to determine their further rehabilitation or care needs
  • They are likely to be able to benefit from inpatient rehabilitation in the near future (such as patients who have a head injury and are in post-traumatic amnesia)
  • They are in a low awareness state (vegetative state or minimally conscious state) and require specialised assessment of their level of awareness (SMART testing)
Are all patients assessed prior to admission?
  • Patients who are admitted from the community are assessed prior to admission in the outpatient clinic, if this is logistically possible. If they are not known to the service, further assessment in their current living situation by the Community Rehabilitation Nurse Team (CRNT) and/or Home-link OT is also arranged prior to admission, if at all possible
  • Patients are also admitted if they have recently been assessed by the CRNT, and in this case, medical review is not required prior to accepting them, unless the CRNT advise that this is necessary
  • All inpatients who are referred from hospitals within Aberdeen are assessed by one of the consultants or the specialist registrar prior to admission. This should be done within one week of receiving the referral. After assessment, an entry must be made in the patient's medical notes, and a letter must be dictated to the consultant in charge, and copied to the patient's GP. If transfer to NRU is not considered appropriate, it is good practice to suggest alternatives if these exist
  • Inpatients in other hospitals in Aberdeenshire are generally assessed prior to admission by a member of the Community Rehabilitation Nurse Team or Home-link OT
  • Patients from Moray or outside Grampian should only be accepted for rehabilitation if a written referral has been received and discussion has taken place over the telephone with the medical or surgical team who are responsible for their care
  • Patients who are in a minimally conscious state should be assessed by a consultant prior to transfer, even if they are being admitted from outwith Aberdeen
How are referrals prioritised?
  • Patients are provisionally added to the waiting list upon receipt of a written referral letter
  • Two or three beds are allocated to patients who are admitted from the community, who require relatively short admissions of only a few weeks
  • Although patients are admitted in order of referral, case mix is also important, and must be taken into consideration
  • If referrals are considered to be urgent, they are given priority over other non-urgent admissions. Referrals are considered to be urgent if the patient is in the community and at risk of harm (e.g. due to deteriorating mobility and falls) or if others are at risk from the patient (e.g. where the patient is aggressive towards carers). However, if patients are severely aggressive, they may require management in an alternative setting (such as the Royal Cornhill Hospital)
  • If a GP telephones the team requesting urgent medical admission because a patient has become medically unwell, this should be discussed with the Specialist Registrar or Consultant. Usually it is most appropriate for the patient to be admitted to hospital via AMAU (Acute Medical Assessment Unit), and review can subsequently be arranged to determine whether there are any ongoing rehabilitation issues, and whether transfer to Maidencraig is still required
  • Most patients who are referred to NRU are very physically dependent, and require a considerable amount of nursing input
Arranging Admissions
  • Following the Admissions Meeting at 1.30 pm on Monday, the secretary who attends the meeting will arrange admission of patients who are being admitted that week
How to refer patients to Neuro Rehabilitation Unit
  • If you wish to refer a patient, please supply a written referral to Dr Nosa Akporehwe or Dr Helen Gooday, Consultants in Rehabilitation Medicine, Department of Rehabilitation Medicine, Woodend Hospital, Eday Road, Aberdeen AB15 6XS (fax no. 01224 556628)
  • If you wish to discuss a possible referral, please feel free to telephone the Department of Rehabilitation Medicine on 01224 556091 or 01224 556582. A consultant or specialist registrar will return your call as soon as possible

There are other out reach services connected to NRU that supply support for patients and relatives on discharge if required:

Headway Website
The Brain and Spine Foundation
Spinal Injuries Association