Service Evaluation of Physiotherapy Referral Pathway

By Omeada Adams, Neurology Nurse Specialist, Chelsea and Westminster Hospital


Rehabilitation of patients at all stages of the disease plays an important role in improving well-being, improving the quality of life, adapting the patient and restoring motor skills and therefore early rehabilitation input is essential.

At Chelsea and Westminster, gait is assessed at all clinic visits to enable the team to put in early intervention by doing physiotherapy referrals to avoid deconditioning.

This project was intended to review the process of the referral pathway currently used.

This is continually assessed for both face to face reviews and telephone reviews. Patients can also email if they do have new symptoms, including a change in their walking or walking difficulties deteriorate.

To evaluate the referral pathway for physiotherapy input.

To identify if this area requires intervention or changes.

78 out of 200 patients were identified as having mobility issues and needed physiotherapy input. 37 were referred by the Neurology nurse, 13 patients referred by the Neurology Consultant or initiated a referral, 6 patients were referred by the GP based on the recommendation of the team via a clinic letter, 15 were self-referred by another route, 3 referrals were initiated by the Neuro pharmacist, 2 patients lived in a borough with no Neuro-rehab service and 2 referred by the Neurology Nurse to the musculoskeletal in the hospital.

This project has highlighted that the current pathway for referrals meets the recommendation for the NICE guidelines, with the only challenge being how to supervise exercise programmes that will prove beneficial.

It will also be helpful if patients can have easy access to self-refer to Neuro Rehab, although this is available, Patients preferred to be referred by health professionals. Tarakci et al., 2021 looked at a 12-week structured exercise program under the supervision and found that it was beneficial and improved patients' health quality of life which was run by a physiotherapist.


Tarakci, E., Tarakci, D., Hajebrahimi, F. and Budak, M. (2021). Supervised exercises versus telerehabilitation. Benefits for persons with multiple sclerosis. Acta Neurologica Scandinavica, 144(3), pp.303–31

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