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About Milestones

Background

Since Sally started working for herself in 1998 her patient list grew to such an extent that it proved increasingly difficult to offer appointment slots to suit her patients.

It became apparent that in order to continue to provide a service Sally would need a permanent base from which to operate. After a prolonged search, the result was a purpose-built clinic in Egham, Surrey, specifically designed to meet the needs of her patients.

Sally decided to name the clinic 'Milestones' because of the Physiotherapist's role in helping patients to solve their problems and achieve their goals and because of the hurdles she had to overcome in finding, securing and then building the property.

Since the Clinic opened in 2004 Milestones has always strived to deliver a comprehensive and specialist service by professionals who have the right set of skills to address the complex needs of people who have a need for neurological rehabilitation.

What is rehabilitation ?

Rehabilitation is a problem-solving and educational process aimed at reducing the functional and social consequences experienced by someone as a result of an injury or disease, always within the limitations imposed by the underlying damage.

The field of neurological rehabilitation provides a service to people with movement, balance and functional difficulties resulting from neurological diagnoses such as ;

• Head injury
• Cerebral palsy
• Multiple Sclerosis
• Stroke
• Parkinson's Disease
• Spinal injuries
• Motor neurone Disease
• Guillain-Barre Syndrome
• Cerebellar degeneration

The injury or disease may affect these people's ;

• Movement control
• Balance
• Sensation
• Speech
• Swallowing
• Vision
• Mood
• Ability to concentrate
• Memory
• Bowel & bladder control

Problem-solving & educational process

1. A person-centred service providing ;

• Integrated assessments and planning
• Goal orientated treatment to support independent living and autonomy
• Practical support and advice
• Information necessary to make informed decisions

2. Comprehensive range of specialist rehabilitation to address the practical and emotional challenges faced by people with a neurological diagnosis

• Specialist multidisciplinary team comprising ;
  • Consultant in Rehabilitation Medicine
  • Occupational Therapists
  • Physiotherapists
  • Speech & Language therapists
  • Orthotist
  • Masseur
  • Personal Trainer
• Can also arrange access to Clinical Psychology, Disability Counselling and Case Management services

3. Prompt, timely, ongoing and high quality rehabilitation services

• Accept self-referrals
• Offer outpatient and community appointments
• Recognised Provider by numerous Private Medical Insurers
• Encourage close liaison & collaboration with National Health Service and Social Care services

4. Education and training for people, their family, carers and support workers

• to enable people to apply the skills acquired in therapy in routine daily living activities
• to develop knowledge and skills to live with and to manage their condition
• to access appropriate vocational assessment, rehabilitation and ongoing support to find, regain or remain in work and to access other occupational and educational opportunities
• to develop local support networks
• to help to achieve a sense of well-being and make long-term psychological adjustments to altered personal, family and social circumstances

Since 2006 we have had our own dedicated multidisciplinary team who are able to provide a specialist service for people who either attend the clinic or need to be seen at home or in the community, all of which is supported by the following publications ;

The National Framework for Long-term Conditions, published by the Government, sets out 11 quality standards focusing upon people with neurological conditions, which are based upon current available evidence and are designed to support these people, improve their quality of life and provide services to support independent living (published March 2005 from DoH www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/LongTermConditions/fs/en

The National Clinical Guideline for Stroke cites evidence which specifies that any continuing treatment required should be provided without delay by a specialist multidisciplinary service at home or on an outpatient basis ( published in July 2008 by the Intercollegiate Working Party for Stroke )

The need for a multidisciplinary service for people with spinal cord injury living in the community has also been well researched. It has shown that people with no access to specialist care have reported lower health status and independence, more depression and higher frequency of secondary complications. ( published in ‘Clinical Rehabilitation’ , the official journal of the British Society of Rehabilitation Medicine ( BRSM ) & of the Netherlands Society of Rehabilitation and Physical Medicine & in association with the society for Research in Rehabilitation : Volume 15, number 6, 2001 )

Evidence based recommendations for providers of treatment to Multiple Sclerosis patients stresses the need for specialist advice / treatment from Physiotherapists, Occupational therapists, Speech & Language therapists and Clinical Psychologists. ( published by the MS Society Spring 2002 )

A document published jointly by the College of Occupational therapists, College of Speech & Language therapists and the Chartered Society of Physiotherapy reports that collaboration between these therapists will ensure co-ordinated and safe management for the patient with swallowing difficulties. ( published by the aforementioned colleges and Chartered Society 1993 ) ·