We have tried to make this genuinely useful rather than a sales page. The numbers are cited. The prices are real. Where the evidence is uncertain, we say so.
What happens locally after a stroke in Blackheath
Blackheath straddles the boundary between the Royal Borough of Greenwich and the London Borough of Lewisham. For the first part of the stroke pathway that makes no difference. For the part that lasts longest, it makes a lot.
The hospital part is the same either side. Hyper-acute stroke care for all Lewisham and Greenwich patients is at King's College Hospital, Denmark Hill — not at your local hospital. You then transfer to University Hospital Lewisham for ongoing rehabilitation, either to Beech Ward (the purpose-built stroke unit on the first floor of the Riverside Building) or Maple Ward (a 24-bed rehabilitation unit with an on-ward gym and kitchen).
The community part depends on which side of the line you live on, and there is no published street-level map of the boundary through Blackheath. The practical test is your postcode and which borough your GP is in.
If you are on the Lewisham side, you come under Lewisham's intermediate care Supported Discharge team, which includes a stroke early discharge pathway. It runs seven days a week, 8am to 8pm, and usually works with people for around four weeks, up to six.
If you are on the Greenwich side, you come under the Neuro Rehabilitation Service – Greenwich, provided by Oxleas NHS Foundation Trust and based at Memorial Hospital on Shooters Hill. It explicitly includes stroke early supported discharge — the only one of the neighbouring boroughs whose provider uses that label — with physiotherapists, occupational therapists, speech and language therapists, a community matron and a clinical psychologist. You can refer yourself if you were seen within the previous six months. You need to be registered with a Greenwich GP.
If you are unsure which applies to you, ask your GP practice. It is a quick question and it determines who turns up at your door.
Where the NHS pathway stops
Nothing above is a criticism of the people delivering it. The constraint is how much therapy is commissioned, not how hard anyone is working.
Here is the gap, in numbers.
National guidance — NICE guideline NG236, updated in October 2023 — recommends at least three hours of therapy a day, on at least five days a week after a stroke. That is the standard the NHS is measured against.
An analysis of 94,905 stroke patients in the UK national stroke audit found that the average therapy actually delivered ranged from two minutes of psychology to fourteen minutes of physiotherapy per day of hospital stay. That figure is averaged across every day of an admission, including days when no therapy happened — so on the days therapy ran, people got more. It is still a long way from three hours.
And in the community, nobody is really measuring. When the national audit added new measures in 2024 to check therapy against the NICE dose, every one of them applied to hospital inpatients only. The single community measure records whether you were seen by a stroke team — not how much therapy you actually got.
What we do differently
We deliver intensive rehabilitation in your home in Blackheath, at a dose closer to what the guideline describes. Up to ten sessions a week if that is what your goals need.
The reason dose matters is not that more hours are automatically better — the evidence is more careful than that, and we would rather tell you so. A Cochrane review in 2021 covering 21 trials and 1,412 people found more time in the same rehabilitation produced only a small gain in limb movement and no significant difference in everyday activities. A randomised trial in 2016 gave people up to 9,600 arm repetitions and found no dose-response effect at all.
What the evidence does support is purposeful, task-specific, high-repetition practice, aimed at the things you actually want to do again. And there the numbers are stark: researchers who sat in on 312 therapy sessions counted an average of 32 arm repetitions per session, while feasibility studies show around 300 in a single hour is achievable when a session is designed for it.
That is the difference we are selling. Not more hours of anything — more purposeful practice per hour, in the room where the movement actually matters.
We measure it, and we show you
Every programme is scored on standard, published measures — the same ones your hospital team used. Depending on your goals, that means the Fugl-Meyer Assessment for arm and leg movement, the Action Research Arm Test for hand function, the Berg Balance Scale, ten-metre walk speed, and the UK FIM+FAM for functional independence.
You get the scores. In writing. Including the ones that have not moved.
What it costs
Published, because you should not have to ask.
| Programme | Sessions | Price per session |
|---|---|---|
| Guided Recovery | 1 a week | £150 |
| Intensive Recovery | 3 a week | £110 |
| Immersion Recovery | up to 10 a week | £100 |
A booster pack of two extra sessions a week is £400.
Every programme begins with a 60–90 minute assessment in your home covering a full clinical assessment, a written rehabilitation plan and a programme recommendation — plus an independent management programme you keep whatever you decide next. We ask you to have a family member, carer or advocate there if at all possible, because rehabilitation rarely works when only the patient understands the plan.
If a programme would put you under real financial strain, we will tell you and recommend a lower-intensity option. That is a promise, not a marketing line.
Common questions
Can I have this alongside my NHS therapy?
Yes, and most people do. Whether your community team is the Lewisham supported discharge service or Oxleas in Greenwich, we work around it rather than replacing it. Tell your NHS team what you are doing so everyone is pulling the same direction.
Is it too late? My stroke was months ago.
Not necessarily. An NHS programme at Queen Square in London ran 90 hours of intensive upper-limb therapy over three weeks with 224 patients who were a median of 18 months past their stroke, and saw a median nine-point gain on the Fugl-Meyer scale that held at six months. That was an uncontrolled study with no control group — the authors say so themselves — so treat it as encouraging rather than proof. But "too late" is said far more often than the evidence supports.
Do you guarantee I will get better?
No. Nobody honest does. Recovery varies between people and always will. We will tell you what we think is realistic after the assessment, and we will show you the measurements either way.
Which areas do you cover?
Blackheath, Greenwich, Lewisham, Charlton, Kidbrooke, Lee, Eltham and the surrounding area — both sides of the borough boundary.
Who you would actually be working with
Your assessment and your programme are led by Tino Mutasa, a neurological physiotherapist registered with the Health and Care Professions Council. Not a coordinator, not a call centre, and not an unnamed "clinical team" — the person who assesses you is the person responsible for your plan.
HCPC registration PH134357 · 07950 445853If you are in Blackheath and want to talk it through, book a home assessment. You will get an honest opinion about whether intensive rehabilitation is likely to help in your situation, and a written plan you keep either way.
This page is general information and not a substitute for assessment by your GP, stroke team or physiotherapist. Every recovery is different.