Manifesto for Home-based Neurological Rehabilitation

Home-Based Neurological Rehabilitation: Manifesto for Community Rehabilitation in Action

Why Home-Based Neurological Rehabilitation Matters More Than Ever

At SP Therapy Services, home-based neurological rehabilitation is both our passion and our purpose. For years, we have advocated for equal access to high-quality, person-centred community rehabilitation for people living with neurological conditions.

Despite progress, many people still lack the specialist support they need, highlighting why the Manifesto for Community Rehabilitation remains vital today.


The Original Call: Manifesto for Community Rehabilitation

In 2018, the UK Acquired Brain Injury Forum (UKABIF), The Chartered Society of Physiotherapy (CSP), and the Royal College of Occupational Therapists (RCOT) collaborated to produce the ground-breaking Manifesto for Community Rehabilitation.

At SP Therapy Services, we proudly supported this manifesto and continue to champion its core principles: equal access to high-quality, person-centred community rehabilitation for all who need it.

The evidence then—and still today—is striking:

  • 44% of people living with neurological conditions could not access community rehabilitation (Neurological Alliance)

  • 13% of people needing physiotherapy could not get access

  • Rehabilitation services were underfunded despite clear evidence of cost-effectiveness

The manifesto demanded action. While some progress has been made, the need for home-based neurological rehabilitation has never been more critical.


Major Developments Supporting Home-Based Neurological Rehabilitation

Since the manifesto, three key developments reinforce the value of home-based neurological rehabilitation:

1. NICE Guidance NG252: Rehabilitation for Chronic Neurological Disorders (October 2025)

The National Institute for Health and Care Excellence (NICE) published NG252 guidance, covering acquired brain injury, spinal cord injury, multiple sclerosis, Parkinson’s disease, motor neurone disease, and more.

Key recommendations supporting home-based neurological rehabilitation:

  • Rehabilitation should be delivered in meaningful settings such as home, work, or community.

  • Person-centred goals must drive therapy planning.

  • Multidisciplinary team coordination across health, social care, and community services is essential.

  • Rehabilitation should be accessible long-term, not just immediately after diagnosis or injury.

  • Intensity and duration of rehabilitation should be tailored to individual needs, not restricted by arbitrary service limitations.

Impact: NICE now endorses flexible, person-centred, long-term, home-based neurological rehabilitation, the very model SP Therapy Services has championed for decades.


2. Neurological Alliance: Act Now for the 1 in 6 (June 2025)

The Neurological Alliance’s My Neuro Survey 2024 Policy Report highlights the challenges people face:

  • Long waiting times for specialist neurological rehabilitation

  • Geographical disparities in service access

  • Chronic underfunding of NHS community neurological services

  • Deterioration in function and quality of life when rehabilitation is delayed

  • Increased healthcare costs from preventable hospital admissions

Impact: For many, home-based neurological rehabilitation is not a luxury—it is essential for timely, specialist support.


3. NHS England’s New Model for Community Rehabilitation (September 2023)

NHS England published the Integrated Care Framework and A New Community Rehabilitation Model.

Key principles:

  • Rehabilitation is as important as medicines and surgery

  • Community-based delivery is optimal for real-world outcomes

  • Preventive rehabilitation is cost-effective (e.g., stroke, falls, COPD, cardiac)

  • Maximising Allied Health Professional workforce and innovation

  • Data-driven planning ensures rehabilitation meets actual needs

Impact: NHS England formally recognises home-based neurological rehabilitation as effective, cost-saving, and life-enhancing—but implementation across the country will take time.


Evidence: Why Home-Based Neurological Rehabilitation Works

Research shows that home-based neurological rehabilitation:

  • Improves functional outcomes by practising skills in the real world

  • Reduces hospital admissions and healthcare costs

  • Enhances quality of life and independence

  • Provides flexible, person-centred support tailored to each individual’s goals


SP Therapy Services: Delivering the Community Neurological Rehabilitation Vision Today

For over 25 years, SP Therapy Services has delivered home-based neurological rehabilitation aligned with NICE guidance and NHS policy:

  • Person-centred, goal-focused rehabilitation

  • Delivered in meaningful environments (home, work, community)

  • Specialist neurological expertise (acquired brain injury, spinal cord injury, cerebral palsy, MS, Parkinson’s, stroke)

  • Flexible, responsive service delivery (no waiting lists, self-referral, tailored frequency/intensity)

  • Coverage across Greater Manchester, Lancashire, and Yorkshire


Who Benefits from Home-Based Neurological Rehabilitation?

  • Individuals funding their own rehabilitation

  • Case managers and solicitors coordinating long-term packages

  • Families and carers seeking expert guidance and support


The Cost-Effectiveness Argument

Investing in home-based neurological rehabilitation preserves independence, prevents hospital admissions, and maintains quality of life.


A Call to Action

The Manifesto for Community Neurological Rehabilitation called for action. NICE, the Neurological Alliance, and NHS England all acknowledge that home-based neurological rehabilitation is essential and cost-effective.

If you or a loved one are struggling to access specialist rehabilitation, SP Therapy Services can help. We deliver the manifesto’s vision—person-centred, evidence-based community rehabilitation—today.

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✉️ Email: info@sptherapyservices.co.uk
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Reviews

Marie Oxtoby

I am the Chair/Co-ordinator of Bolton Neuro Voices, a small local charity. I first contacted SP Therapy Services in 2012 when I was looking for a neuro physiotherapist to help us pilot a new Hydrotheraoy Course for people with long-term neurological conditions. Since then Susan Pattison and her staff have helped us to deliver ten courses to a total of more than 200 people and to facilitate the progress of many on to ongoing Continuation Programmes. Her expertise and willingness to listen and respond to our needs and those of our very varied participants is hugely appreciated and our partnership has gone from strength to strength. I unreservedly recommend this practice.

Amanda Knight

Andy provided a very thorough and considered physiotherapy assessment of a client with complex needs. His report was to a very high standard and underpinned all immediate and long term therapy needs. Thank you!

Elaine O'Flaherty

Very professional service and high quality of reports and communication to ensure best practice and outcomes for my clients.

Suzanne

SP Therapy Services has supported Greater Manchester Spinal Injury Group for many years. Susan and Rebecca have demonstrated knowledge and skill and been adaptable to working in community settings. I would have no hesitation in recommending SP Therapy Services

Janet Penny

I am delighted to endorse the team at SP Therapy Services. They consistently provide exceptional therapy and support their practice with sound, detailed documentation, which always arrives in a timely manner. The friendly clinicians are a credit to this fabulous company and it is evident that they always keep their patients at the centre of everything they do.