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Clinical services at Queen Square

INPATIENT SERVICES

NEUROREHABILITATION UNIT (NRU) QUEEN SQUARE

Who do you treat?  ?  The Neurorehabilitation Unit at the National Hospital for Neurology and Neurosurgery is an 18 bed Level 1 in-patient unit which is commissioned to provide complex specialist neurorehabilitation. It predominantly admits patients from across North Central London and the wider region who are in hospital with acquired neurological impairments. This includes patients with stroke, subarachnoid haemorrhage, traumatic brain injury, CNS inflammatory disorders, spinal cord lesions, neuropathies and a range of neurological disorders. It has particular expertise in the multidisciplinary management of patients with complex neuro-disability, both physical and cognitive, requiring in-patient neurorehabilitation. The aim of the NRU is to optimise individuals’ physical, psychological, communication, social and vocational / educational function through provision of a focused, responsive multidisciplinary inpatient service. 

What services are available?  The NRU offers specialised rehabilitation for patients who would benefit from integrated multidisciplinary rehabilitation involving at least three of the NRU therapy disciplines (physiotherapy, occupational therapy, speech and language therapy and psychology) in addition to medical and nursing input. We also have a dedicated social worker who can work closely with patients and their families when required. Discharge planning proceeds in parallel with neurorehabilitation, working closely with the patients and their families. Each patient’s length of stay is defined according to their clinical need and potential, as identified by the multidisciplinary team within the first two weeks. On average this is around 3 months. If at the end of the planned neurorehabilitation period it is not possible to complete discharge planning, then patients may be returned to their referring hospital or another suitable location.

Guidelines for admitting patients to the NRU:  We admit patients with complex specialist neurorehabiltation needs that cannot be met in a local or Level 2 setting. (1)  In practical terms, the person needs to be able to tolerate activities in sitting position for at least two hours twice daily, and to participate in a goal-oriented rehabilitation programme. (2) Patients must therefore have sufficient exercise and skin tolerance to participate in an intensive rehabilitation programme. (3) Patients should ideally be above 18 years of age. Patients between 16 and 18 years of age will also be considered provided it is felt that the NRU meets the needs of the patients better than any other service. (4)  Patients must be medically stable. A patient must meet the criteria listed above on their day of admission to the NRU. With regards to patients whose medical condition is fluctuating, the referring medical team must ensure that such a patient is re-assessed prior to the patient's transfer and that they still meet the admission criteria. Patients who are medically unstable on arrival will be transferred back to an acute inpatient bed. Patients with significant cognitive or behavioural difficulties who would require a specifically resourced and specialised programme to focus on these areas may not be suitable for NRU admission. For patients of this type, we can advise on other specialist rehabilitation services which may be more suitable. We do not accept patients with predominantly functional neurological symptoms, or those determined to be in a Prolonged Disorder of Consciousness. 

Who provides the clinical service?   Clinical services are provided by a multi-disciplinary team which is led by a Consultant Neurologist, a Consultant in Rehabilitation Medicine, a Consultant Neuropsychiatrist, a Consultant Occupational Therapist, a Consultant Physiotherapist, a Consultant Speech and Language Therapist, a Band 8b Neuropsychologist, a Social Worker, and a Charge Nurse. There is access also to music therapy and art therapy.

How are referrals made?  Referrals are made via the Badgernet online referral system, to which linked hospitals have access. Organisations which do not have access to this system can also make referrals: please contact the NRU administrator on uclh.nhnntherapyrehabadmin@nhs.net with any enquiries.

Are there any research studies that patients could be involved in?   Patients will have access to ongoing clinical trials where appropriate.

 

SPASTICITY MANAGEMENT SERVICE

Who do you treat?    Anybody with troublesome spasticity.  The majority of our inpatients are people who have been reviewed in the outpatient multidisciplinary clinics with problematic spasticity who require admission for trial of intrathecal baclofen or phenol.  Patients are admitted to the NHNN under the care of the spasticity team.

What services are available?     Trials of intrathecal baclofen proceeding to pump implantation when appropriate.  Intrathecal phenol - candidates for intrathecal phenol are admitted to access a trial with local anaesthetic and subsequent intrathecal phenol treatment.  Patients admitted to the NHNN / UCLH can be referred to the spasticity team for assessment whilst an inpatient. This enables them to gain access to a multidisciplinary review and treatment (including Botulinum toxin, Sativex and assessment for intrathecal treatments).

Who provides the clinical service?    Clinical services are provided by Consultant Neurologists, specialist nurses, and specialist physiotherapists.

How are referrals made?  Referrals should be made directly from the UCLH team to the Spasticity Team via email uclh.spasticityteam@nhs.net or contacting the department on 020 34483561. 

Are there any research studies that patients could be involved in?   Patients will have access to ongoing clinical trials where appropriate. 

OUTPATIENT THERAPY

PHYSIOTHERAPY

We are committed to providing evidence based, cost effective, high quality specialist tertiary outpatient therapy service for neurological & vestibular conditions. As a tertiary service we offer education and support to physiotherapists on a local and national level, contributing to research and development of guidelines.

Who do you treat?   The physiotherapy outpatient team at NHNN assesses and treats people with neurological conditions who experience movement difficulties, mobility or balance issues.

What services are available?    The physiotherapy Outpatient service offers a specialist service for assessment and advice for ongoing management of neurological conditions:

  • We provide specialist services for a wide range of neurological conditions including ataxia, HSP, PPA, MND, neuromuscular, movement disorders, MS, PRION diseases, metabolic, brain and spinal tumours and HD.
  • We offer specialist services for vestibular rehabilitation, FES, orthotics, Splinting & expert MDT clinics for Ataxia and MND.
  • We carry out comprehensive assessments in line with evidence based practice and local and national guidelines, contributing to differential diagnoses and provide comprehensive assessment reports.  
  • Following assessment, we provide excellent patient care through:
  • Partnership with other specialist services at NHNN
  • Providing advice and education to patient, family and carers
  • Identification and referral to the most appropriate provider of treatment
  • Making recommendation and liaising with local services
  • Offer specialist interventions where appropriate

Who provides the clinical services?  The physiotherapy team consists of Clinical Specialist and senior physiotherapists, all of whom have specialised in neurology.

How are referrals made?   The service is available to patients over 16 years of age who have a NHNN Consultant who have a need for neurological physiotherapy. Referrals are accepted from NHNN Consultants and their team and other Therapists at NHNN Referrals should be made via EPIC

Are there any research studies that patients could be involved in?  Patients will have access to ongoing clinical trials of upper limb treatment where appropriate.

 
    OCCUPATIONAL THERAPY

    Who do you treat?     The Occupational Therapy outpatient team at NHNN assesses and treats people with neurological conditions who experience any difficulties performing every day activities such as work, self-care or leisure tasks. Patients must be under the care of a UCLH /NHNN consultant.

    What services are available?   

    • The occupational therapy outpatient service offers expert assessment and advice for ongoing management of people with problems in performing everyday activities and roles due to a neurological condition.
    • We provide specialist services for a wide range of neurological conditions including Multiple Sclerosis, ataxia, Hereditary Spastic Paraplegia (HSP), Motor Neurone Disease (MND), neuromuscular conditions, movement disorders, metabolic conditions, brain and spinal tumours and Huntington’s Disease.
    • We offer specialist services for vocational rehabilitation, fatigue management, splinting & expert Multi-Disciplinary Team (MDT) clinics for Ataxia and MND.
    • We carry out comprehensive assessments in line with evidence based practice and local and national guidelines, contributing to differential diagnoses and provide comprehensive assessment reports.
    • We will liaise closely with local outpatient and community services where appropriate. In all cases we will advise on how to achieve long term self-management where able.
    • Following assessment, we provide excellent patient care through: Partnership with other specialist services at NHNN; Providing advice and education to patient, family and carers; Identification and referral to the most appropriate provider of treatment; Making recommendation and liaising with local services; Offer specialist interventions where appropriate

    Who provides the clinical service?    The Occupational Therapy outpatient team consists of clinical specialist and senior occupational therapists, all of who have specialised in neurology.

    How are referrals made?    The service is available to patients over 16 years of age who have a NHNN Consultant who have a need for neurological occupational therapy. Referrals are accepted from UCLH/ NHNN Consultants and their team and other Therapists at NHNN.   Referrals should be made via the Electronic Healthcare system (EPIC) via: OP REFERRAL TO OCCUPATIONAL THERAPY - NEUROSCIENCES [REF624]
    Are there any research studies that patients could be involved in?  Patients will have access to ongoing clinical trials where appropriate.
    SPEECH AND LANGUAGE THERAPY

    Who do you treat?  The speech and language therapy team at NHNN assess and treat people with neurological conditions who experience communication and/or swallowing problems.

    What services are available? 

    • The speech and language therapy Outpatient service offers specialist assessment and advice for the ongoing management of communication and swallowing disorders due to neurological conditions.
    • We provide a specialist service for a wide range of neurological conditions including stroke, ataxia, motor neurone disease, neuromuscular conditions, movement disorders, multiple sclerosis, brain tumours, Huntington’s disease, functional neurological disorders, and primary progressive aphasia.
    • We contribute to expert MDT clinics in ataxia, cerebral palsy, complex facial rehabilitation and motor neurone disease.
    • We carry out comprehensive assessments in line with evidence-based practice and local and national guidelines, contributing to differential diagnoses and provide comprehensive assessment reports. 
    • Following assessment, we provide excellent patient care through:
      • Partnership with other specialist services at NHNN
      • Provision of advice and education to patient, family and carers
      • Identification and referral to the most appropriate provider of treatment
      • Making recommendation and liaising with local services
      • Offer specialist interventions where appropriate

    Who provides the clinical service?   A speech and language therapist with specialised knowledge in neurology and all aspects of communication and swallowing relating to neurological conditions.

    How are referrals made?    The service is available to patients over 16 years of age who have a NHNN Consultant and have a need for speech and language therapy. Referrals are accepted from NHNN Consultants, their teams and other therapists at NHNN.  Referrals should be made via EPIC.

    Are there any research studies that patients could be involved in?   The SLT department is currently running a research study exploring the feasibility of laryngeal ultrasound in detecting disorders of vocal fold movement. We are also affiliated with the Dementia Research Centre and UCL aphasia clinics where research is ongoing.

    SPECIALIST NEUROREHABILITATION SERVICES

    UPPER LIMB NEUROREHABILITATION SERVICE

    The Queen Square Upper Limb Neurorehabilitation Programme is an NHS service that was started at the National Hospital for Neurology and Neurosurgery in 2014 - more detail here

    Who do you treat?   Patients with neurological upper limb deficits. 

    • The focus of the intensive 3 week upper limb programme is achieving individualised goals relating to functional tasks, as well as setting people up to continue with their improvement after they leave.
    • The intense goal-directed nature of the programme is best suited for people with some forward reach and at least the beginnings of thumb and/or finger extension.
    • The key is the ability to participate in goal-directed training and so those with stiff and painful shoulders and/or problematic spasticity in wrist and fingers are likely to need these problems managing before considering admission to the programme.
    • Please consider whether people will tolerate a 3 week intensive programme, considering conditioning, fatigue, cognition.
    • It is a day-attender programme and so most people will need to be relatively independent.

    What services are available?  

    • Assessment and advice on symptom management. 
    • Where approriate, we can offer a place on the 3 week upper limb neurorehabilitation programme at Queen Square - more detail here

    Who provides the clinical service?  The service is run by Professor Nick Ward (Consultant Neurologist), Fran Brander (Consultant Physiotherapist), and Kate Kelly (Consultant Occupational Therapist), all with expertise in assessing and treating upper limb problems.

    How are referrals made?  GPs should refer via the NHS electronic referral system using the following information

    • Hospital: UCLH
    • Speciality - Rehabilitation
    • Service - Multidisciplinary Neurorehabilitation for the Upper Limb Clinic - NHNN - Queen Square- RRV
    • Clinic Type - Neuro-rehabilitation

    Consultant to consultant referrals should be sent to: Professor Nick Ward, Professor of Clinical Neurology and Neurorehabilitation, The National Hospital for Neurology and Neurosurgery, Box 146, Queen Square, London WC1N 3BG, or by email to nick.ward4@nhs.net

    For administrative matters relating to the Queen Square Upper Limb Rehabilitation Programme please email uclh.referrals.upper.limbadmin@nhs.net

    For queries about the waiting list, please contact uclh.referrals.nhnnchooseandbook@nhs.net

    Are there any research studies that patients could be involved in?   The Programme offers a unique opportunity to investigate how we can further our understanding of recovery of the upper limb after focal brain injury through a range of studies using brain imaging, neurophysiology or behavioural measurements. Taking part in research studies is an integral part of the programme

    VOCATIONAL REHABILITATION

    Who do you treat?    Adults with a neurological disorder who are finding that their condition/symptoms are impacting on their ability to do their job, find work, or study.

    What services are available?    This is a specialist vocational rehabilitation service that looks at how your diagnosis impacts on work, and works with you to find solutions to the problems your diagnosis creates at work or study.  Once we receive your referral we will contact you by letter or phone to advise you as to our waiting list or to offer you an appointment.  At your first clinic appointment you will meet a multi-disciplinary team who will  take details of your history, find out about your current problems and needs, prioritise your areas of difficulty,  discuss with you the options for your therapy and treatment and identify a treatment plan/goals and time frame, and refer you on to your local service or other services here at NHNN if this is more appropriate.  We may ask you to fill out some questionnaires to help us monitor our service.

    Having agreed a treatment plan we will work with you to solve the problems that your diagnosis creates in your ability to work/study. We will also help you and your employer to identify any reasonable adjustments that may be suitable to enhance your working life. Often we will offer to meet with your employer or come and work with you to solve difficulties.

    At the end of your planned treatment you will be given a period of time where you can come back and see us in case problems arise (open access).

    Who provides the clinical service?    A Consultant Neurologist will review the diagnosis and how this impacts on work.

    A Clinical Psychologist will assess any changes in thinking skills and how this may affect your work performance. The Clinical Psychologist is also interested in your adjustment to any new challenges and can offer help with coping strategies and mood difficulties related to these challenges. There's also a focus on your identity at work and the factors that may influence your confidence and self-esteem.

    Occupational Therapists will assess how any difficulties you have may affect everyday working and how these may be managed, e.g. fatigue, physical adjustments and time management. They can also do a work analysis and pinpoint what strategies you may implement that could improve your working life.

    We may refer you to our Physiotherapy and Speech and Language colleagues if these are people who could help you.

    Together these professionals will help remove any barriers that interfere with your potential to achieve what you strive for in spite of your neurological diagnosis.

    How are referrals made?         

    Are there any research studies that patients could be involved in?   Patients will have access to ongoing research studies where appropriate.

    GENERALISED SPASTICITY MDT CLINICS

    Who do you treat?    We offer advice on the management of patients with any neurological disorder who are troubled by spasticity or spasms.

    What services are available? 

    • A detailed spasticity assessment and report.
    • Advice on symptom management and optimisation of function.
    • Treatment options include physiotherapy, splinting, oral medication, recommendation for botulinum toxin, intrathecal baclofen or phenol.
    • Where required, we will make referrals to other NHNN services (e.g., Functional Electrical Stimulation clinic, specialist vocational rehabilitation clinic, orthotics clinic).
    • We will liaise closely with local outpatient and community services where appropriate.
    • In all cases we will advise on how to achieve long term self-management where able.
    • A multidisciplinary service for people with cerebral palsy

    Who provides the clinical service?  The service is run by Consultant Neurologists who work within a multidisciplinary team of Clinical Nurse Specialists and Physiotherapists.

    How are referrals made?     The service is available to all patients over 16 years of age.  Referrals are accepted from GP’s via NHS E-referrals (UCLH- rehabilitation- spasticity) or by letter from hospital Consultants, and should be sent to:  The Spasticity Service, The National Hospital for Neurology and Neurosurgery (Box 113), Queen Square, WC1N 3BG

    Are there any research studies that patients could be involved in?  Patients will have access to ongoing clinical trials of spasticity management where appropriate.

    Further information on spasticity here

      FOCAL SPASTICITY MDT CLINICS

      Who do you treat?    Anybody with a central process causing spasticity / stiffness involving limited muscle groups which may be amenable to treatment with Botulinum toxin. In general this is one or two limbs.  Conditions we commonly treat include:   Stroke, Multiple Sclerosis, Cerebral Palsy, Spinal Injury, Spinocerebellar Ataxias / Freidreichs Ataxia

      What services are available?    Outpatient clinics offer assessment and treatment with Botulinum toxin. Patients will be called prior to their appointment to gather background information and arrange physiotherapy follow up if required. 

      Who provides the clinical service?   The service is provided by Consultant Neurologists and Specialist Neurophysiotherapists.

      How are referrals made?     Referrals are accepted from GP’s via NHS E-referrals (UCLH- rehabilitation- spasticity) or by letter from hospital Consultants, and should be sent to:  The Spasticity Service, The National Hospital for Neurology and Neurosurgery (Box 113), Queen Square, WC1N 3BG

      Are there any research studies that patients could be involved in?    Patients will have access to ongoing clinical trials of FES where appropriate.

      Further information on spasticity here

      ORTHOTICS MDT CLINIC

      Who do you treat?

      • We offer a specialist orthotics service for patients with neurological conditions including non progressive and progressive conditions as well as treating patients with rare neurological disorders which require orthotic intervention such as Charcot-Marie Tooth Disease, hereditary spastic paraplegia, dystonia and ataxia. 
      • Many of these conditions require regular follow up as their disorder evolves with age such as in Duchenne muscular dystrophy.
      • We also offer custom made helmets for patients with severe epilepsy or other problems such as an unprotected craniotomy post surgery.

      What services are available?

      • A detailed assessment by an orthotist and senior physiotherapist .
      • Provision of prefabricated/ off-the shelf or custom-made devices based on the patient’s clinical needs.
      • A thorough discussion on how to use and maintain the orthosis.
      • Advice on exercise including stretching.
      • When appropriate we will suggest further therapy input and make referrals to the appropriate team.
      • Where required, we will make referrals to other specialist services e.g. spasticity service, Functional Electrical Stimulation service, specialist vocational rehabilitation clinic.
      • We also make referrals where appropriate to orthopaedic teams at UCLH or Stanmore.
      • In all cases we will advise on how to achieve long term self-management where able.

      Who provides the clinical service?  The service is run by a Clinical Specialist Physiotherapist, an orthotist, and a Consultant Neurologist.

      How are referrals made?  The service is available to all patients over 16 years of age with a neurological disorder that requires an orthotic assessment. Referrals are accepted from GPs via the NHS electronic referral system, Consultants Neurologists at NHNN/UCLH, and physiotherapists at NHNN.  Referrals should be sent to: Orthotics Team, Box 64. The National Hospital for Neurology and Neurosurgery, Queen Square, WC1N 3BG.

      Are there any research studies that patients could be involved in?   We work closely with the MRC Centre for Neuromuscular Diseases and many patients are involved in trials through the Centre.

      COMPLEX FACIAL REHABILITATION SERVICE

      Who do you treat?   We offer facial rehabilitation for people with facial weakness following damage to the cortico-bulbar pathway, the facial nucleus and/or the facial nerve and its branches.  The most common reason for referral is following Bells Palsy or Ramsey Hunt Syndrome.  The service also provides continuity of care for people following surgery at The National Hospital for Neurology and Neurosurgery for acoustic neuroma / vestibular schwannoma as well as those who have undergone recent facial reanimation surgery. We also receive referrals for people with facial asymmetry following stroke and Guillain Barre Syndrome. 

      What services are available?  

      • The service offers detailed assessment and report
      • An individualised facial rehabilitation programme using a neuromuscular approach to facilitate a range of facial expressions and function
      • Outcome measurement using the Facial Grading System, Facial Disability Index and individualised patient goals
      • The service also offers an advisory role to Physiotherapists and Speech and Language Therapists at the National Hospital for Neurology and Neurosurgery and is responsive to external enquires.

      Who provides the clinical service?   A Consultant Neurologist, Clinical Specialist Physiotherapist, and Clinical Specialist Speech and Language Therapist.

      How are referrals made? Referrals are accepted for people over the age of 16 years who have a need for facial rehabilitation from consultants at The National Hospital for Neurology and Neurosurgery / UCLH (via EPIC), and GPs should refer via the NHS electronic referral system.  Referrals should be sent  electronically to The Complex Facial Clinic (GC1F1) at The National Hospital for Neurology and Neurosurgery, Box 113, Queen Square, London WC1N 3BG.

      Are there any research studies that patients could be involved in?  There are no research studies currently underway.

      TRAUMATIC BRAIN INJURY

      Who do you treat?   We provide a dedicated and comprehensive multi-disciplinary outpatient follow up service for Traumatic Brain Injured (TBI) patients. This includes patients discharged from Major Trauma Centres, other Trauma Units and those presenting to GPs and other clinicians.  This patient group have complex physical, cognitive, affective and behavioural needs that require specialist ongoing care and support.

      What services are available?   We provide an initial Consultant-led multi-disciplinary Brain Injury clinic appointment to fully assess the patient and their needs. This clinic presents an opportunity for specialist neurological, neuropsychological and endocrinological assessment, with access to specialist neuro-radiological diagnostic imaging during the clinic, followed by referral to relevant community-based and/or in-hospital services.  All patients have access to comprehensive neuropsychological assessment, individualised cognitive feedback, rehabilitation as indicated, and our Brain Injury Intervention Group – a workshop run by our dedicated Neuropsychologist providing psychological education, cognitive strategies and support for adjustment.  We also have access to NHNN specialist services: where appropriate, we may involve other specialist teams at the NHNN:  Neuro-ophthalmology; Uro-neurology;  Neuro-otology; Complex post traumatic epilepsy; Neurorehabilitation and vocational rehabilitation; Post traumatic Headache; Neuro-endocrinology; Neuropsychiatry; Pain Management; Sleep Disorders; Spasticity Management.  We also have strong links with external community based provision including social services, community rehabilitation teams and Headway.

      Who provides the clinical service?    The clinic is staffed by Consultant Neurologists, Clinical Neuropsychologists, a Consultant Neuro-endocrinologist with expertise in the consequences of traumatic brain injury, and a Clinical Nurse Specialist.

      How are referrals made?    The service is available to all patients over 16 years of age.  Referrals are accepted from any NHS doctor in the UK including trauma surgeons, neurosurgeons, neurologists and GPs who should refer via the NHS electronic referral system Referrals can also be made directly from trauma centres by members of the trauma MDT.  Referrals can be made via the Traumatic Brain Injury Clinical Nurse Specialist (CNS) run telephone hotline or email service or by post.

      TBI Clinical Nurse Specialists:  Direct Tel: 020 3448 4303020 3448 4303; email: UCLH.TBIreferrals@nhs.net, or send to:

      Traumatic Brain Injury Outpatient Service

      The National Hospital for Neurology and Neurosurgery

      Box 125, Queen Square

      London, WC1N 3BG

      Are there any research studies that patients could be involved in?   Patients will be able to participate in research looking at the consequences of trauma on brain structure and function and also exploring new treatment options.

      FUNCTIONAL ELECTRICAL STIMULATION (FES)

      Who do you treat?  We offer advice on the management of patients with any upper motor neurone neurological disorder who have difficulty walking due to dropped foot.

      What services are available?  A detailed walking assessment and report. Advice on symptom management and optimisation of function. Trial of functional electrical stimulation (FES) and if appropriate loan of equipment and long term support. Where required, we will make referrals to other NHNN services (e.g. physiotherapy, upper limb Functional Electrical Stimulation clinic, focal or generalised spasticity clinics, specialist vocational rehabilitation clinic, orthotics clinic). We will liaise closely with local outpatient and community services where appropriate.

      Who provides the clinical service?   The service is run by a Consultant Neurologist and a Physiotherapist.

      How are referrals made?   The service is available to all patients over 16 years of age.  Referrals are accepted from GP’s via the NHS electronic referral system (UCLH- rehabilitation- FES) or by letter from hospital Consultants, and should be sent to:  The FES Service, The National Hospital for Neurology and Neurosurgery (Box 113), Queen Square, WC1N 3BG

      Are there any research studies that patients could be involved in?   Patients will have access to any ongoing clinical trials of FES where appropriate.

      Further information on FES here

       
      APHASIA CLINIC

      Who do you treat?   Patients with acquired brain injury causing speech and language impairment (e.g., speaking, listening, reading, writing), and patients with any cause of brain injury e.g.: stroke, head injury, tumour, hypoxia; but not dementia.

      What services are available?    

      • The Specialist NHS Aphasia Clinic has been established to provide therapy and advice to people with aphasia and to speech and language therapists. The clinic is a partnership between the neurology service, National Hospital of Neurology and Neurosurgery, UCLH NHS Foundation Trust and the University College London.
      • The Intensive Comprehensive Aphasia Programme@Queen Square is for adults who have aphasia caused by an acquired brain injury, usually stroke, brain tumours or head injury. It is currently funded by The National Brain Appeal and is awaiting NHS commissioning status:

      Who provides the clinical service? 

      • Prof Jenny Crinion - Professor of Cognitive Neuroscience and Consultant Speech and Language Therapist.
      • Prof Alexander Leff - Professor of Cognitive Neurology and Consultant Neurologist who specialises in cognitive and language problems in stroke, dementia and other neurological diseases.

      How are referrals made?   The service is available to all patients over 16 years of age.  Referral for the initial clinic appointment, will need to be processed electronically by the patient’s GP via the NHS electronic referral system, or hospital consultant. To book patients via the eRS system into the Aphasia Clinic at 'The National Hospital for Neurology and Neurosurgery in Queen Square' please select the following options below:

          National Hospital for Neurology & Neurosurgery (NHNN)

          Outpatient Services

          Rehabilitation

          Neuro- rehabilitation

          Aphasia Clinic

      Are there any research studies that patients could be involved in?    Patients will have access to ongoing clinical trials of speech and language treatment where appropriate.

      HEMIANOPIA MDT CLINIC

      Who do you treat?   Patients with hemifield disturbances, reading or other higher-level visual & visuo-spatial dysfunction (e.g.: neglect).   We see patients with any cause of brain injury e.g.: stroke, head injury, brain tumours. More information here

      What services are available?    A multi-disciplinary ‘one-stop’ clinic for patients with hemifield disturbances, reading or other higher-level impairments of object or space perception (e.g. spatial inattention, also known as neglect).

      The clinic offers:

      • Assessment by: by a neurologist, a neuropsychologist and an orthoptist. Providing an “eye to brain” examination.
      • Rehabilitation: compensatory strategies for reading and other visual tasks.
      • Advice: on fitness to drive (DVLA) and partial sight registration.
      • Treatment: for any underlying cause.

      Who provides the clinical service?   A Consultant Neurologist, a Clinical Neuropsychologist, and an Orthoptist.

      How are referrals made?   The service is available to patients of any age (those under 16 years of age can be seen but require more paperwork).  Referrals accepted from any NHS doctor in the UK, but preferably from the patient's GP via the NHS electronic referral system as follows:

      Ø NHNN

      Ø Outpatient Services

      Ø Neuro-rehabilitation

      Ø Rehabilitation

      Ø Hemianopia

      For Consultants to refer:

      If working @UCLH, please refer via EPIC ‘add orders’ and search for hemianopia clinic

      If working outside UCLH, please email me a short referral letter with the patient’s address,  contact number, NHS number and GP address to: alexander.leff@nhs.net

      Are there any research studies that patients could be involved in?   Patients are often suitable for one of the free-to-use, online, web-based therapies for patients with hemianopia: Eye-Search and Read-Right

      Other clinical services

      UCL Communication Clinic