Anna Duff is a highly specialist and experienced physiotherapist working at the National Hospital for Neurology and Neurosurgery.  She is involved in the treatment of a wide variety of complex neurological and mobility difficulties, and has recently joined the Queen Square Private Consulting Rooms to bring her services to private patients and consultants in Queen Square.  We spoke with Anna to discover more about her specialty and how her work contributes to the multidisciplinary management of neurological conditions here in Queen Square.

Q: Thank you for taking the time to speak with us today Anna.  Firstly, would you begin by describing your role here in Queen Square and your particular areas of expertise?

I am a Highly Specialist Physiotherapist and have worked at Queen Square since 2012.  Over this time I have worked on the neuromedical wards, Neurological Outpatients, The Neurological Rehabilitation Unit, Neurosurgery and am now on the Hyper Acute Stroke Unit. I have a particular interest in neurological rehabilitation and have been exposed to a diverse range of Neurological conditions using therapy adjuncts such as electrical stimulation and orthotic provision. I have been working privately alongside my work at NHNN so am well aware of the exciting challenges and potential pressures of private practise.

Q: What led you to want to specialise in physiotherapy for neurological conditions. Does physiotherapy in this field differ from physiotherapy for other conditions?

I had a keen interest in Neurological physiotherapy as a student and purposefully exposed myself to research in stroke for my master’s dissertation. My desire to specialise in the area was immediate once graduating however it was imperative I built the foundations as a holistic therapist and therefore I completed general rotations before specialising on the Stroke Unit at a district General Hospital. I had always wanted to work within a leading centre for Neurological Conditions and therefore moved to Queen Square as a specialist to expose myself to the best therapists and doctors in the field.

Personally, I feel Physiotherapy in this area differs from many areas in terms of complexity of conditions and the holistic MDT approach that is required for successful management of a neurological patient.  Physiotherapy provides an important role in education for self-management at multiple stages of disease progression and addresses the specific patient goals to achieve for a more fulfilling quality of life.

Q: ‘Queen Square’ is renowned for the breadth and depth of expertise and neuro-specialties available in one location. How does physiotherapy contribute to the multidisciplinary management of neurological illness?

Physiotherapy works at the forefront, alongside the multidisciplinary team on management of neurological conditions. A lot of patients suffer difficulties with balance, dizziness, weakness, Neuromuscular and postural changes to their skeletal system which all affect their mobility or utilisation of their upper limbs in function. We are able to work alongside the medical team in providing fast and efficient treatment programmes to minimise the negative impact of a disease process. Proactive prevention is better than cure, therefore using a physiotherapists skills early on for education and assessment is important to enable our patients to be as high functioning and independent as possible, and to prevent secondary changes. We work alongside Occupational Therapists, Speech and Language Therapists, Psychologists and orthotists to ensure all needs are met. I have access to highly qualified OTs and SALTs that are able to work with the patients, alongside myself, to ensure comprehensive management.

Q: How much of a difference can this specialist form of physiotherapy make to a patient suffering from neurological disability?

Quite often patients are not aware of what can be done from a therapeutic stand point for their condition or disability. We are able to work with the patient to improve their baseline fitness, strength and flexibility to enable them to return to work, complete regular exercise, look after family members or socialise with friends etc. Whatever the client wants to achieve we can look at how or whether this is achievable with necessary modifications and or hard work. Our expertise in Neurological Conditions means we can put programmes into place to avoid unnecessary secondary changes during the disease process and empower the patient to recognise signs of deterioration whilst having the tools to know what to do about it. Having a sense of control in uncertain times can help improve self-confidence, give hope and lift mood in what is often a difficult time in patients’ lives.

Q: What can a patient expect from a consultation with you?

I will complete a full assessment of the patient which will involve establishing what the patient feels are their main difficulties and what they want to gain from therapy, and what their goals are. I will complete a full Neurological examination which may include analysing movement patterns, strength, coordination, balance and postural control.  Next I will establish the most appropriate treatment plan for the patient based on their main impairments and limitations. I will assist in helping the patient set realistic measurable goals and will ensure the patient is educated on the best plan moving forward. I will finally advise on the most appropriate frequency and intensity of therapy required as well as signposting to any other services required.

Q: You offer a physiotherapy service whereby you will see patients in their own homes. What benefit does this bring to the patient?

I primarily see people in their home as quite often people with reduced mobility or fatigue can find coming into clinic appointments difficult. I try and fit around the patients schedule so that therapy is convenient and therefore patients are more motivated. I am able to provide a more individualised programme in their own familiar environment and see exactly how they are managing with everyday tasks. I can suggest environmental adaptations that may make life easier or reduce risks of falls etc. Finally it reduces the costs and difficulties with traffic or public transport when travelling to appointments. I am also able to see people in the clinic at Queen Square and will do everything I can to coordinate this with other appointments patients may have to ensure it is as convenient as possible.

Q: Does a patient need to be referred to you by a consultant in Queen Square, or can a patient self-refer? Are they able to use their health insurance to see you?

I am able to accept consultant referrals or self-referrals and am keen to build strong relationships with the consultants at Queen Square to enable us to be Multidisciplinary in our approach to treating Neurological conditions. Every health insurance company has different rules regarding who is able to see their patients. I have worked with insurance companies on a number of occasions and am looking to register with more. If the patient would like to discuss this further I am happy to offer advice.

Q: If a referrer would like to contact you, or if a patient is interested in seeing you in your clinic at the Queen Square Private Consulting Rooms, how can they go about organising this?

I am available to discuss referrals on the phone (07944535814) as well as via email (annaduff@specialisedphysio.com). Alternatively referrers can be directed to my website www.specialisedphysio.com where they can leave a message for further information. I will establish a time that works for the patient and book the next available clinic space at Queen Square Private Consulting Rooms.