Community neuro-rehabilitation

Service overview

Our community neuro rehabilitation services are for people over the age of 16 years of age who have neurological conditions requiring rehabilitation.  We assess the patient's healthcare needs and work with them to plan and agree a rehabilitation programme to help them achieve their goals.

Who we are:

Our teams include, or have access to a range of clinical specialities including:

  • physiotherapy
  • occupational therapy
  • speech and language therapy
  • dietetics
  • podiatry
  • psychology
  • orthotics
  • rehabilitation assistants
  • injury prevention team for carers
What we do:

Our services provide for people with neurological impairments caused by conditions such as stroke, traumatic brain injury, multiple sclerosis, Parkinson's disease and motor neurone disease.

We provide assessment, treatment and advice to clients and carers regarding:
  • Indoor/outdoor walking practice
  • Promoting independence with daily activities, e.g. meal preparation, bathing
  • Swallowing, eating, drinking
  • Communication - speaking,(articulation or voice), understanding, reading, writing
  • Cognitive - e.g. memory and attention
  • Emotional difficulties
  • Fatigue management
  • Work, education and leisure
The teams includes an early supported discharge for stroke service, providing intensive rehabilitation at home for up to 6 weeks following discharge from hospital. We carry out reviews of the needs of stroke survivors at 6 and 12 months after their stroke and our stroke support team provide practical assistance and emotional support for those in the first year following a stroke.

Please be advised that the phone number for the community neuro-rehabilitation service at St Charles Centre for Health and Wellbeing is: 
0208 102 5017.


This information is for GPs and other healthcare professionals who refer patients to our community rehabilitation teams.

Who can refer?

  • patients
  • relatives
  • healthcare professionals
  • social services and other organisations 

This service is for:

  • housebound patients although some outpatient clinics are available
  • over 18 years of age
  • registered with a GP in Hammersmith and Fulham, Kensington and Chelsea, Merton and Westminster
  • patients where neurological diagnosis is the reason for the referral

This service is not for:

  • provision of equipment or housing adaptations
  • needs are around ongoing case management

How to refer to our services:

Hammersmith and Fulham, Kensington and Chelsea and Westminster

E-Fax: 0300 008 3251

Queries only0300 033 0333 
Further information Single Point of Access (SPA) page


T: 0333 004 7555
Efax:  0300 008 2122

Discharge criteria

Patients can be discharged when they have reached their full rehabilitation potential, have achieved their rehabilitation goals, or where there is no clinical benefit to continued rehabilitation.

Patients can also be discharged back to the care of their GP if they fail to attend appointments.


Needs Based Assessment

All acute Trusts in North West London can use the Needs-Based Assessment Form to refer patients to our intermediate care services in Hammersmith & Fulham, Kensington & Chelsea, and Westminster.
Referrers can download and complete the form when referring to one of our relevant services. These are:
  • District nursing
  • Community Independence Service/ Integrated Community Teams
  • Community Rehabilitation Service and Falls
  • Community Neuro-Rehabilitation
  • Rapid Response Nursing Teams

Depending on the Borough the patient lives in, the Single Point of Access details are:

Queries and referrals for district nursing
Queries relating to CLCH neuro-rehabilitation in Hammersmith & Fulham, Kensington & Chelsea and Westminster will be processed through the single telephone number - 0300 033 0333.

The new 0300 033 0333 telephone number for CLCH Services is to be used for queries only.

Referrals for neuro-rehabilitation should be sent to:

E-Fax: 0300 008 3251
Further information: Single Point of Access (SPA) page



Useful links

Please see links to some other useful websites on related topics:


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