Richmond Community Neuro Rehabilitation Team

HRCH.jpgRichmond Community Neuro Rehabilitation Team (CNRT) is an NHS service for adults with a neurological condition who are living at home. The team works with patients and carers to help them achieve maximum independence in all aspects of daily life. Therapy is delivered to patients in the most appropriate setting, either as an outpatient at Richmond Rehabilitation Unit, or at their home or workplace setting.

Richmond MS Nurses.JPGAcceptance Criteria:

Adults (18 years+) registered with a Richmond GP and who have an acquired or long-term neurological condition. The main problem identified must relate to their neurological diagnosis. 

CNRT is not appropriate for:

People whose primary diagnosis is:

  • learning difficulties
  • mental health problems
  • substance misuse
  • dementia  (however the SLT service provides swallow assessment and advice for these patients, please see Departments & Services) 

The CNRT team consists of specialist therapists and nursing (please see Departments & Services for more information):

  • Neuro-Physiotherapy
  • Occupational Therapy
  • Speech and Language Therapy (SLT)
  • Dietetics
  • Multiple Sclerosis Nursing
  • Parkinson’s Nursing  

Stroke Early Supported Discharge Team (ESD)

In addition to the CNRT, there is also an Early Supported Discharge (ESD) Team based at Richmond Rehabilitation Unit. This is an intensive rehabilitation service for stroke patients to facilitate early discharge home from hospital.

There are also links to the Continence Nurse Specialist and Podiatry Service


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Online survey for adults

Contact details

Team Manager: Cate Campbell

020 8614 7350

Richmond Rehabilitation Unit,
22 Evelyn Road,

Opening times:


Making a compliment, suggestion or complaint: 

The trust’s Patient Advice and Liaison Service (PALS) provides advice and support to patients, their families and carers. It also provides on-the-spot help to sort out any problem you may have with local health services.

You can contact PALS on Freephone 0800 953 0363 FREE or by email:

How to refer

All referrals to the community neuro rehabilitation team should be made via Single Point of Access (SPA) using the HRCH single referral form.   

physio at workWho we are

We are highly specialised physiotherapists with experience in treating people with neurological conditions. Our assessments and treatment programmes use detailed analysis of movement and how it impacts on every day function.

The aim with all treatment programmes is to facilitate the service user to self-manage their condition as much as possible and to support care givers. 

 What we do

The key elements that we provide for patients with neurological conditions are: 

  • Detailed and specific assessment of postural control and normal movement to include muscle flexibility, strength, tonal changes, and joint range of movement

  • Assessment of motor skills - bed mobility, transferring, sitting and standing balance, walking, managing stairs and getting up from the floor.

This is achieved by:

Task specific practice and strengthening programmes in home or gym environment including practice with carers. 

Re-education of balance and gait. 

Provision of appropriate walking aids including orthotics and/or referral to a specialist clinic. 

Spasticity Management including -
           Individually tailored stretching and positioning programmes. 
           splinting and provision of equipment.
           Referral on to spasticity clinic  
           Provision of timely rehabilitation following Botox injections.

Positioning and Posture Advice to include education on 24 hour positioning and posture to carers.  This aims to maximise function and aid recovery, prevent secondary complications e.g. contractures, deformity and pressure sores.  

Group Therapy

Several exercise groups are run at Richmond Rehabilitation Unit which include the General exercise class and the Balance class.  The aim of these groups is to promote maintenance and/or improvement in optimal level of physical ability, support individuals through group interaction and encourage people as well as adopting a self- management approach to healthy living and exercise.

Who we see

We see people diagnosed with a neurological disorder and who have a Richmond GP.

Who we  don't see

People whose primary problem is any of the following:

  • Learning disability

  • Mental health problem

  • Substance misuse

  • Dementia

  • Traumatic injury or new medical condition unrelated to their neurological condition. E.g. a fracture or pneumonia

  • Multiple active unresolved medical needs taking priority over their underlying neurological condition

  • Peripheral neuropathy related to alcohol or diabetes

  • Single nerve palsy related to trauma

  • Nerve root involvement related to disc protrusion

  • Non-organic conditions and M.E

OT photo 2015.jpgWho we are

We are a team of specialist Occupational Therapists trained to assess and treat neurological disorders.

What we do

Occupational Therapy  (OT) provides practical support to help increase peoples independence, enabling people to do the activities (occupations) that matter to them. This could be essential everyday tasks such as looking after yourself, work or leisure.

Areas of intervention can include

  • Personal care tasks
  • Household tasks
  • Productivity and leisure activities, including guidance on employment and driving
  • Arm and hand function
  • Functional mobility and transfers
  • Fatigue management 
  •  Adapting to changes in vision, visual perceptual difficulties (e.g. homonymous hemianopia, figure ground.)
  • Cognitive rehabilitation (e.g. memory, attention)
  • Equipment to aid independence


Who do we see

We see all patients registered with a Richmond GP who have a neurological condition (e.g. stroke, Parkinson’s, multiple sclerosis) and are having difficulty participating in everyday tasks.

Who don’t we see
Patient’s whose needs are for equipment or environment adaptation only- please contact Richmond Social Services Adult Access  team, 020 8891 7971.

speech therapists talkingWho we are

We are a team of neuro-specialist Speech and Language Therapists trained to treat communication and swallowing disorders. 

What we do

We assess, diagnose and, where appropriate, provide goal-led therapy programmes. We support with alternative means of communication. We provide safe swallowing recommendations for people with swallowing difficulties relating to the mouth and throat (oral-pharyngeal dysphagia). Please note: oesophageal stage difficulties should be referred to gastroenterology.

Acquired communication disorders

Dysarthria (unclear speech): difficulty achieving clear or loud speech secondary to a neurological condition, eg, Parkinson's

Aphasia (language impairments): difficulties understanding and expressing spoken or written language 

Cognitive Communication Disorder: communication disorder primarily associated with cognitive impairment  

We provide direct therapy which may be 1:1 or group therapy. We also provide education, advice and support to family and carers.  

In addition, we can refer into local communication groups that offer long-term support e.g. Moving On Stroke Club, Dyscover, Integrated Neurological Services

Who do we see

We see adults with a neurological diagnosis, who are registered with a Richmond GP and who present with communication or swallowing difficulties.

In addition, we see people with dementia, COPD and other non-neurological conditions for swallow assessment and advice (dysphagia). 

Who don’t we see 

People with non-neurogenic voice disorders: Please refer to Specialist Voice Therapy SLT Team at the Heart of Hounslow, Bath Road, Hounslow.

People with a developmental or acquired stammer:  please refer to City Lit or see the British Stammering Association website 

People with difficulty swallowing secondary to an oesophageal diagnosis. Please refer direct to gastroenterology.

People with communication difficulties secondary to dementia.

Hospital SignWhat we do

  • To integrate patient’s nutritional treatment into their overall CNRT care
  • Provide impartial and evidence based advice about nutrition and health for a range of neurological conditions.
  • Advise on food related problems, treatments and disease.
  • Advise on dietary management to limit future neurological events e.g. stroke
  • Ensure dietary advice is person specific and meets nutritional needs
  • Raising awareness of importance of good nutrition with patients, carers, health and social services, family and friends.
  • Work jointly with other team members and other professionals e.g. Speech and Language Therapists for patients with dysphagia (swallowing problems)
  • To support and counsel patients throughout their  decision regarding artificial nutritional support e.g. Percutaneous Endoscopic Gastrostomy (PEG)


Who we do not see

Kingston Hospital Dietetic Department  has the funding for enteral tube feeding e.g. PEG for patient’s registered with a Richmond GP.

Who we are

  • Janice Newbery - Multiple Sclerosis Nurse Specialist
  • Wioletta Kironde - MS Administrator  

What we do

  • Support,advice and information for patients who have recently been diagnosed with MS

  • Ongoing support for patients with MS and their carers via telephone or direct contact

  • Specialist nursing assessment and advice on the management of MS, working closely with therapy colleagues within the Community Neuro-Rehab Team      

  • Links between community and hospital services      

  • Case management for patients with complex needs      

  • Links to other services supporting people with MS, making referrals when required 

  • Education and training for health and social care professionals involved in MS 


Find more information on our webpage

Parkinsons nurse.JPGWho we are

  • Neda Rahmani-Khezri - Parkinson's Nurse Specialist (Monday to Wednesday)

What we do 

The Parkinson’s Nurse Specialist provides patients with information and advice to support and help self-manage condition.

This local service in Richmond is aimed at helping maintain a good quality of life for patients  and their family/carer through:

  • Advocacy

  • Support for patients, families and carers

  • Facilitating medication management

  • Management of symptom control

  • Providing co-ordination of care with other professionals that are involved

  • Education about condition and how to self-manage

  • Information and advice

  • Telephone advice line 

We provide a 6-week PD exercise class and also run a weekly newly diagnosed PD clinic alongside a physiotherapist. In addition, we also offer a newly diagnosed PD education group which is run twice a year.

Who do we see

The service is available for patients who:

  • Are registered with GP in Richmond

  • Have a confirmed diagnosis of Parkinson’s

  • Are already known to the service so self-referrals are accepted

  • Are experiencing problems associated with Parkinson’s

The Parkinson’s Nurse Specialist can provide advice over the phone, at clinic or at home for house bound patients.

Find more information on our webpage:

physio at work.jpgWhat we do

The stroke early supported discharge team provides an early, intensive rehabilitation service for stroke patients.

The team helps patients to leave hospital more quickly and return to their own homes so that patients can maximise independence as quickly as possible after their stroke.

Patients are referred directly from stroke units or rehab units and are assessed within one working day (Monday to Friday).

Treatment is intensive in the home for the first two weeks. After this time treatment will gradually reduce in intensity over the next four weeks.

Patients may also be supported by a care package or district nurse if needed and must be organised prior to discharge. Any equipment must also be organised prior to discharge.

Who we are

Memory Musamadya
MSC – Specialist Neuro Mental Health Practitioner (Psychological Patient Support Service)

What we do

This service supports patients with a neurological diagnosis who experience psychological symptoms, including anxiety, low mood and feeling overwhelmed which is impacting their rehabilitation and general wellbeing.

Every patient is supported with tools that work for them, to let the patient take control of their life and not let the symptoms control them.

In cases where some patients experience advanced symptoms which are a high risk to their life or others, we can refer to secondary mental health services, emergency services, GP or Kingston and Richmond Assessment Team for an advanced mental health assessment.

Patients can be referred from within the CNRT Team, from other teams within HRCH, from external services or from patients/carers themselves.

Once known to Neuro Wellbeing services within HRCH, patients can be re-referred to our team via Single Point of Access (SPA).

Please find information on common neurological conditions listed below.




Multiple Sclerosis (MS)


Parkinson’s Disease (PD)


Motor Neurone Disease


Traumatic Brain Injury


Brain Tumour

Pressure ulcers (also known as pressure sores or bedsores) are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin.

They can happen to anyone, but usually affect people confined to bed or who sit in a chair or wheelchair for long periods of time



For more information, please visit page below:


Anyone with an infection can get sepsis. It can be life threatening and difficult to spot. Please see link below for more information on symptoms and advice.


Urinary Tract Information (UTI)

If you are concerned that you may have a UTI, please see the link below for a list of symptoms and advice


Chest infection

If you are concerned that you have a chest infection, please see the link below for a list of symptoms and advice



What should I do if I fall? (pdf)

Falls and injury booklet (pdf)

If you are concerned about any aspect of your emotional or mental being, please see the links below

If you are looking after and support your partner, parent, relative or friend, please see the links below for more information:

Richmond Carers Centre

Integrated Neurological Services

Funding and Social Care