Inpatient Physiotherapy :: Northern Care Alliance (2025)

TheAcute Neurology Unit is a busy specialist ward for complex neurology patients from the whole of Greater Manchester.

We see a wide variety of patients admitted withneurological conditions, for example:

• Multiple Sclerosis

• Motor Neurone Disease

• Guillain Barre Disease

• Functional Neurological Disorder

• Encephalitis

• Parkinson’s Disease

• Spinal Stroke

• Myelitis

We carry out thorough assessments and assist the Neurologists in their diagnostic process.We also offer advice regarding how each patient should transfer or mobilise. This may involve specialist equipment or seating, provision of walking aids, splints and supports.

Treatment plans are guided by the patients’ own goals and may include treatments such as:

• Exercise prescription

• Sensory stimulation

• Gait re-education

• Building exercise tolerance

• Mirror therapy

• Balance rehabilitation

• Respiratory care and advice

We also representPhysiotherapy in specialist clinics such as the Greater Manchester MND Care Centre andtheIntrathecal Baclofen Pump clinic.

Our team of Physiotherapists work as part of an integrated multi-disciplinary team across Accident and Emergency and the Emergency Assessment Unit, providing cover from 8am-8pm Monday – Friday and 8am-4pm Saturday/Sunday.

The therapists complete specialist therapy assessments/specialist neurological assessments / cognitive assessments, to identify a patient’s current physical, functional, cognitive and mobility deficits and to establish needs for discharge, on-going support and rehabilitation.The therapists focus to ensure patients are managed safely and effectively without admission wherever appropriate, linking closely with our community services for on-going therapy needs.

TheAgeing and Complex Medicineteam provides an integrated therapy service to the acutegeriatricmedicalwards in addition to cardiology, gastroenterologyand the regional renal unitamongst others. All patients deemed appropriate by the multidisciplinary team (MDT), are referred for the appropriate specialist therapy assessment. Patients may be seen jointly by an OT and Physiotherapist or by just one discipline, dependenton their needs.Therapy input is directed towards maximising functional capacity in order to promote quality of life.

The types of specialist assessmentsthat may be requiredinclude:

• Functional mobility and transfers

• Activities of daily living (ADL)

• Cognition (e.g.attention, memory and concentration)

• Mood (anxiety and low mood)

• Chest / breathing problems

• Continence

• Feeding & nutrition

• Seating, posture and pressure care needs

• Wheelchairs

The interventions and support for our patients may include:

• Education and advice for acute and long term condition and symptom management

• Acute rehabilitation to enable discharge from the hospital setting

• Onward referrals for relevant specialist interventionor rehabilitation

• Issuing of equipment for home to improve independence and safety

• Signposting for community services

• Carer support

Ourphilosophy is holistic, client-centred care. We work with our patients to help them achieve the maximum level of independence possible, and realise a timely and safe discharge from hospital.

We provide specialist input to the acute Major Trauma and Major Trauma Rehabilitation wards, working closelywith the occupational therapists and the wider multidisciplinary team, to work towards common goalsin linewith patient wishes. We involve patients and families in their care, encouraging self -management of conditions or injuries and assist in supporting them emotionally through their journey.

Our Role Involves:

• Specialist assessment and treatment of patients following simple and complex injuries. These can occur as a result of major traumae.g.road traffic collision, falls or sporting accidents.

• Co-ordinating structured routines and encouraging early mobilisation of patients, in order to improve their overall outcomes.

• Delivering a wide range of treatment options, which can include respiratory care, exercise prescription, seating assessments, mobility and balance re-education.

• Co-ordination of care based on individual needs, factoring in previous conditions such as lung disease, dementia, mental health conditions etc.

• Prescribing and delivering education on the use of specialist equipment.

• Assisting in the co-ordination of complex dischargesfrom hospitaland provision of onwards care with community rehabilitation teams.

Types of Injuries:

• Our patient can be from 16 years upwards

• Their injuries may include:

• Single or multiple limb fractures,including the foot and hand

• Joint /ligament injuries

• Brain injuries

• Spinal cord injuries

• Rib fractures

• Spinal fractures

• Pelvic fractures

TheNeurosurgery therapy team specialises in the assessment and treatment of neurosurgical conditions such as traumatic brain injury,spinal cord injury, brain haemorrhage, brain and spinal cord tumours and planned (elective) spinal surgery.

Weassess and treat patients withneurological deficits,such as:

• Weakness

• Changes in sensation

• Co-ordination problems

• Increased muscle activity

• Balance

• Communicationor cognitivedifficulties

• Respiratory problems such astracheostomy, chest infection orpoor cough effort;

In addition, the Neurosurgery team assess and treat critically ill patients within the Critical Care Unit (CCU). This may involve treatments to improve their chests and lungs while on a ventilator or to assist the patients to wean (come off) from the ventilator. As patients within the CCU improve medically, the therapy team will start early rehabilitation to promote their recovery.

As the Neurosurgery service at Salford is a regional service, patients may be transferred to a hospital or community health care setting closer to home to continue their rehabilitation.This will usually be after a short period of recovery, when no further surgery is required.

Our therapy teamcommunicatewithand support patients and family members through what can be adifficult and unpredictable time, working with the wider multi-disciplinary team towards patient-centred goals.

OurStrokePhysiotherapists are part of a multi-professional team providing assessment and treatment for patients who have been admitted onto our hyperacute, acute and stroke rehabilitation units.Everyone who is admitted with a stroke is entitled to a therapy assessment within 24hours, and theseare often completedjointlywith an occupational therapist to ensure there is a holistic picture gathered of a person’s problemsand to plan functional goal effectively.

Rehabilitation will be designed based on the patient’s needs and initial assessments, and the team will work with the patient and their families to set specific rehabilitation goals. The physiotherapists will assess in detail how the stroke has affected the ability to move and treatment will aim to improve posture, balance,co-ordination,limb weakness and physical function.Specialist equipment, such as de-weighting treadmills and orthotics, can be used alongside neurological handling techniques to improve recovery.

Therapy is an on-going process which continues throughout the day with all members of the ward team.Thestaffmeet through dailyboard roundsto facilitate safe and timely planning of discharges from the hospital setting.If on-going therapy is required, the wardtherapistswill liaise with colleagues in Community Services to ensure there is an effective handover of care.

Our Orthopaedic Physiotherapy team are responsible for looking after patients who have been admitted following either traumatic orthopaedic injuries or elective surgery. Assessment and treatment is designed to enhance recovery, commence rehabilitation as soon as the patient is able, promote independence and support patients to leave hospital as quickly and safely as possible.

Patients requiring on-going physiotherapy on leaving the hospital may be discharged home with community physiotherapy support or transferred into Intermediate Care Unit, dependent on level of need.

Our wardbased therapy team of Physiotherapists work closely with ourOccupational Therapists, Assistant Practitioners and Therapy Assistants as well as the wider multi-disciplinary professions such asSpeech and Language Therapy, Dietetics, Nursing, Medicsand Psychology.

We provide specialist management for patients with complex neurological rehabilitation needs in the early stages of their recovery. Each patient is different andtheaims of rehabilitation may range from achieving basic physical abilities up to full integration back to all previous activity.

The types of patients we seeinclude:

• Acquired or traumatic brain injury

• Stroke

• Brain or spinal tumours

• Spinal cord injury

• Spinal surgery

• Neurological conditions e.g. Guillain Barre Disease

We assess and treat patients with a neurological deficit which may include the following:

• Muscle weakness

• Sensory changes

• Co-ordination problems

• Reduced mobility / balance

• Prolonged disorder of consciousness

• Cognitive difficulties

• Respiratory problems such as tracheostomy, chest infection or poor cough effort

We carry out thorough assessments and implement management plans and treatments guided by individual goals. This may involve specialist equipment or seating, provision of walking aids, splints and supports, exercise prescription, sensory stimulation, gait re-education, balance rehabilitation, respiratory care and advice, cognitive rehabilitation andfunctional task practice.

Our Respiratory Physiotherapy Team work across both inpatient (critical care unit and wards) and outpatientsettings.

Our outpatient service offers assessment and treatment for patients with long term respiratory conditions such as bronchiectasis and hyperventilation syndrome.

As an inpatient service, our Physiotherapists work across Critical Care, Medical High Care, Surgical High Care, Heart Care, Respiratory Care Wards and Surgical Care Wards.Ourrole is split into two main areas: respiratory care and rehabilitation.

We provide specialist assessments for patients with both acute and chronic medical conditions,and deliver treatment and advicein order tosupportyourmedical recovery,reduce and managerespiratorysymptomsand tofacilitate your discharge out of hospital. We also work with patients pre-operatively, during their inpatient stay and follow them up after elective surgery in line with the enhanced recovery pathway.

The aim of Physiotherapy is to help restore ormaintain respiratory function, movement, strength, mobility and functional ability to patients who have had an illness, injury or surgery. Our Physiotherapists are committed to providing a service that is responsive topatientneed, innovative and based on current evidence and research. In partnership with each patient,and/or their families or carers, they plan treatment toenhance an individual’s recovery andto ensure a timely, safe and successfuldischarge from hospital.

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