Service Specification and Admission Criteria
Name of unit
Location (Tel)
Main groups treated
Primary service
description
Inclusion criteria
Exclusion criteria
Main services offered
Frank Cooksey Rehabilitation Unit, King’s College Hospital NHS Foundation Trust
4th Floor Riverside Building, Lewisham Hospital NHS Trust, Lewisham High Street, London SE13 6LH
Tel: 0208 333 3365; Fax: 0208 333 3027
Patients who have reached their sixteenth birthday, who are recovering from:
 Acquired brain injury of any cause.
 Incomplete cervical spinal cord lesions, and incomplete or complete thoracic or lumber spinal cord
lesions (of any cause), if a referral to a Regional Spinal Cord Injuries Centre (RSCIC) has been
made but access is delayed, or if they have been declined.
 Peripheral neuromuscular disease e.g. Guillain Barré syndrome, critical illness neuropathy,
polymyositis.
 Complex musculoskeletal injury and associated physical rehabilitation needs
 Neurological injury and amputation (Upper or lower limb)
Post-acute intensive specialist in-patient neurological and complex rehabilitation for patients recovering
from acquired disability.
 People with complex neurological disability (i.e. physical disability, often with cognitive and/or
communication problems), who require more than one intensive therapy discipline (OT, PT, SLT)
and/or psychology. These patients’ needs are such that they require an inpatient stay in a
specialised unit to optimise their recovery. A capacity assessment must have been completed
where indicated.
 Patients who require a short intensive and specialist physical rehabilitation, in the absence of a
primarily neurological injury or illness
 Patients coming to the unit from home for intensive specialist physical rehabilitation following
change of weight bearing status e.g. touch/ partial /full.
 Patients with the following; vac dressings/ pumps, ng tube, colostomy bags, peg feeding, external
fixators on limbs, and spinal braces.
The unit does not accept patients with the following problems, which are usually best managed in
other centres (as indicated in brackets below):
 Patients who are ineligible to receive NHS-funded rehabilitation care
 Patients for whom no discharge destination has been agreed
 Persistent Vegetative States and Minimally Responsive States (RHND Putney)
 Patients with severe cognitive and behavioural problems without physical disability (Lishman Unit,
BBIRU, Blackheath BIU)
 Severe behavioural problems which could not be managed in this environment e.g. requiring the
need of 1:1 care (the Kemsley Unit, RHND Putney)
 Patients treated under the Mental Healthcare Act (BBIRU)
 Patients who are not medically stable
 Patients requiring ongoing respiratory monitoring, invasive or non-invasive respiratory support, or
tracheostomy care
 Patients who do not to consent to a referral being to FCRU
 Patients who cannot commit to abstain from self-injurious behaviours for the duration of their
inpatient rehabilitation stay e.g. substance and alcohol misuse
 Referring Trauma Consultant (e.g. Orthopaedic surgeon, plastic surgeon) declines to make a
commitment to continue to provide care and ongoing management prior to acceptance or
admission.
 Smoking is not permitted on the unit and patients who cannot commit to restrain themselves from
smoking may find it difficult to adapt to the environment1
Inter-disciplinary rehabilitation programme including:
 Post acute rehabilitation for people recovering from acute insult or injury, to help them make the
1 FCRU is a non smoking unit. University Hospital Lewisham is a non-smoking site. FCRU staff may schedule time off the
unit for patients wishing to smoke outside away from hospital grounds, no more than twice a day, if portering staff are
available.
Capacity
Mean in-pt LOS
Features of the
service in relation to
service specification
standards
Waiting time for
admission
Main outcome
measures recorded
Other reported
outcomes
Audit and Clinical
governance
transition from hospital back to home/community (LOS usually 1-3 months). Team comprises of
Consultants in Rehabilitation Medicine, Consultant therapist in neuro-rehabilitation, nursing,
physiotherapy, occupational therapy, speech and language therapy, psychology, and administrative
staff
 Liaison with Younger Physical Disability services, and other community-based health services such
as Headway, intermediate and continuing care therapy teams and social care agencies
 Rehabilitation follow-up (in a Rehabilitation Medicine clinic) and other medical and/or surgical
follow-up as required.
Total 15 beds : 2 x4-bed, 7 single rooms
Usually 1-3 months, typically 8 weeks
 Inter-disciplinary programme with agreed short- and long-term goals, (which are patientdetermined, wherever possible)
 Goal-setting begins within two weeks of admission, and goals are reviewed at two week intervals
 Access to early prosthetic/ walking aid equipment e.g. PPAM aid, parallel bars
 Access to prosthetic services via clinic.
 Hydrotherapy for complex physical and neurological injuries.
 Discharge planning starts from point of admission, involving social services, PCTs, housing and
relevant community rehabilitation and care teams, voluntary services etc.
 Preparation for discharge may include graded exposure to the community, for example weekend
leave.
 Family and carer support offered as an integral part of the programme
 A key-worker is allocated to each patient to act as a case co-ordinator.
 Specialist equipment funding requirements are addressed, and negotiated with the patient’s local
PCT or social services as necessary
 A family conference is held approximately 2-3 weeks into admission to discuss likely outcomes,
discharge destination etc.
 Written information is provided to patient and family before and during stay
 A discharge summary and care plan are given to patient and family
 Assessment within two weeks of receipt of completed referral
 Admission typically 2-4 weeks from acceptance by the multidisciplinary FCRU team
 UK FIM+FAM (Functional Independence measure and Functional Assessment Measure)
 Other function- and impairment-based measures as appropriate (eg American Spinal Injuries
Association , “ASIA”, for SCI)
 Rehabilitation Complexity Scale
 UK-ROC
 Discharge destination (against predicted discharge destination)
 Length of Stay
 Patient/family feedback questionnaire
 Adverse incidents and ‘near miss’ register
 Record of plaudits and complaints.
 All staff participate in yearly appraisal and objective-setting/ monitoring
 Multi-professional 360 Degree appraisal included every 2-3 years for medical staff
 Rolling audit of outcomes and patient feedback.
Updated 26/04/2013, FCRU Team