Areas we cover · Dulwich

Stroke rehabilitation at home in Dulwich

If you or someone in your family has had a stroke and you live in Dulwich, this page explains what the NHS pathway gives you locally, where it stops, and what intensive rehabilitation at home costs if you decide you want more.

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 Dulwich

Dulwich sits mostly in Southwark, with parts in Lambeth, so a stroke here goes to King's College Hospital at Denmark Hill — one of London's eight hyper-acute stroke units, on the fifth floor of the Ruskin Wing. King's aims to get a head scan and diagnosis done within 30 minutes of arrival.

Because you are local to King's, ongoing inpatient care usually stays there, on the Friends Stroke Unit on the same floor, which holds both high-dependency and rehabilitation beds. Patients from further afield get transferred back to a hospital nearer home; you generally will not.

Then you go home.

Community stroke rehabilitation for Dulwich is provided by Guy's and St Thomas' — their community stroke and neuro-rehabilitation service, delivered in your own home. It is a broad team: rehabilitation consultants, physiotherapists, occupational therapists, speech and language therapists, neuropsychologists, nurses and social workers. It works to goals you set, and reviews your needs six months after your stroke. You can refer yourself if your stroke was within the last six months.

A useful quirk of living in Dulwich: the boundary between Southwark and Lambeth runs along Croxted Road, and West Dulwich straddles it. For most services that matters. For stroke rehabilitation it does not — the Guy's and St Thomas' service covers both Lambeth and Southwark, so either side of Croxted Road reaches the same team. You do need to be registered with a Lambeth or Southwark GP.

One thing the service does not cover: it excludes wheelchair assessment, hand therapy, equipment and adaptations, and it cannot take patients needing feeding tubes for swallowing difficulties. Urgent swallowing referrals are seen by speech and language therapy within two to three working days.

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 Dulwich, 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. We are not a replacement for the Guy's and St Thomas' community team — we work around 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?

Dulwich, East Dulwich, West Dulwich, Herne Hill, Peckham, Camberwell, Sydenham and the surrounding area.

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 445853

If you are in Dulwich 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.