NROL is the Neuro Rehabilitation OnLine programme, jointly run by East Lancashire Hospitals NHS Trust (ELHT) and the University of Central Lancashire (UCLan) helps to support survivors of stroke and brain injuries, meaning they can access help in their own homes rather than having to attend hospital.
The scheme, which uses online video sessions to provide group specialist neurorehabilitation, was created because the Covid-19 pandemic affected the number of patients who could access face-to-face and group-based NHS treatment.
Following the success of the first NROL programme with UCL and UCLH NHS Trust, a second programme was funded by SameYou with East Lancashire Hospitals NHS Trust.
SameYou funded the expansion programme after they were awarded £219,859 funding over two years from The National Lottery Community Fund, the largest funder of community activity in the UK, which allowed the expansion of the programme through ELHT, Lancashire and South Cumbria NHS Foundation Trust, University Hospitals of Morecambe Bay NHS Foundation Trust and Blackpool teaching Hospitals NHS Foundation Trust.
The Trust was chosen by SameYou and UCL Queen Square to run the service due to their commitment to providing high quality rehabilitation and their improvement of clinical services through research.
ELHT is a key member of the Lancashire and South Cumbria Integrated Stroke and Neurorehabilitation Delivery Network, which forms part of the NHS national stroke strategy. Following the pilot scheme, their plan is to use a network approach to deliver the service in the North West of England, providing maximal impact in one of the harder hit areas of the Covid-19 pandemic.
What is NROL?
NeuroRehabilitation OnLine (NROL) is a group rehabilitation programme for people who have had a stroke or have other neurological conditions.
The aim of NROL is to provide additional group-based rehabilitation sessions to people in their own homes, to increase access and opportunity for neurorehabilitation and encourage social support as part of a community.
Currently NROL is run by 4 NHS partner Trusts across Lancashire and South Cumbria (East Lancashire Hospitals NHS Trust, Lancashire and South Cumbria NHS Foundation Trust, University Hospitals of Morecambe Bay NHS Foundation Trust and Blackpool Teaching Hospitals NHS Foundation Trust).
NROL is delivered online using the video conferencing platform Microsoft Teams, technology support is provided from a NROL Tech Support team member. NROL includes physical, talking and community groups. These groups are delivered by therapists from the neurorehabilitation and stroke therapy teams.
Ongoing evaluation is undertaken alongside NROL to understand how it fits within the NHS and its challenges and successes. The lessons learnt from the evaluation help inform further development and improvement of NROL.
The expansion of NROL
NROL was developed and piloted by University College London , with support from SameYou, in response Covid-19 pandemic when the number of patients who could access face-to-face and group-based NHS treatment was affected.
Following the success of the pilot a second NROL project was funded by SameYou and run jointly by the University of Central Lancashire and East Lancashire Hospitals NHS Trust. East Lancashire Hospitals NHS Trust was chosen by SameYou and University College London due to their commitment to providing high quality rehabilitation and their improvement of clinical services through research which is enhanced by their clinical academic partnership with the University of Central Lancashire. This second project explored if and how NROL could be embedded into NHS services.
An NROL upscale project is now being funded by SameYou after they were awarded £219,859 funding over two years from The National Lottery Community Fund, the largest funder of community activity in the UK. The upscale allows the expansion of the NROL programme regionally across NROL NHS partner Trusts within Lancashire and South Cumbria.
Who takes part in NROL?
Patients undertaking outpatient or community neurological rehabilitation can be referred by a treating therapy staff member to participate in NROL to complement their existing rehabilitation.
Over 200 patients have participated in NROL from Lancashire and South Cumbria since January 2021.
This included patients with a range of neurological conditions and time since diagnosis, ages (18-88 years) and deprivation levels.
Patients participate in a mix of physical, talking and community groups dependent of their need.
What staff are required to work on NROL?
Groups are run by a multidisciplinary team comprising therapy staff (allied health professional and psychology), assistant practitioners, and patient volunteers. Student involvement is supported.
Coordination of the programme is provided by a dedicated NROL coordinator and supported by an NROL administrator. To facilitate access to NROL, staff and patients are provided with set up and ongoing technical support by a dedicated NROL technology staff member.
Leadership for NROL is provided by East Lancashire Hospitals NHS Trust and University of Central Lancashire project leads.
Data to date indicates that NROL provides staffing efficiencies compared to face to face rehabilitation delivery (0.6 vs 1.0). This supports our current staff to provide more rehabilitation to patients that need it.
What is the patient and staff feedback?
Through interviews and satisfaction surveys, there has been positive patient and staff opinions of NROL as an 'extra layer of therapy' that enhances existing rehabilitation.
There were many examples of how NROL benefitted patients’ lives, for example improving confidence and ability.
“NROL has inspired me to draw the curtains back and face my challenges and fears ...thank you so much you gave me back my song and dance.”
"Having suffered a stroke last year my life turned upside down. NROL helped me in no end of ways, and I gained so much knowledge and help from all of the team and other patients.”
"You’re not tired when you arrive. It's easy, it's manageable, and you can do it. It's done and you can integrate it into your life”
The NROL project was a finalist for the North West Coast Research and Innovation Awards - Ruth Young Award for Research Implementation. The University of Central Lancashire/East Lancashire Hospital NHS Trust collaborative submission was the only shortlisted that was specific to Allied Health Professionals.
If you want further information about NROL please contact Professor Louise Connell, [email protected]