Services for the elderly
The Bryning Unit is a multidisciplinary team running a weekly programme of outpatient clinics and groups to provide assessment, rehabilitation and support for older people with complex problems.
Referrals come from GPs, hospital consultants after an inpatient stay, district nurses, therapists, Social Services and sometimes after a visit to A&E.
The team includes nurses, therapists, doctors, a carer’s specialist and a Parkinson’s specialist.
There are a wide range of clinics and groups which occur on the Bryning Unit
- Medical clinics run by our specialist consultant geriatricians
- Memory clinic
- Leg ulcer clinic nurse-led for people with complex leg ulcers
- Falls clinic designed to identify any causes of falls and thus help to prevent future falls
- TIA clinic (Transient Ischaemic Attack) for people suspected to have symptoms of a stroke that are short-lived and have resolved
- Syncope clinic investigating people who have blackouts, unexplained dizziness, light-headedness or falls
- Parkinson’s Disease and Movement Disorder Clinic for people with suspected or known Parkinson’s disease or other conditions which can affect movement and muscle control
- Continence clinic, nurse-led clinic for people who have urinary problems
- Balance Rehabilitation Class called Strong & Steady, designed for people who have balance difficulties
Things to bring with you to your appointment:
- your appointment letter
- current medication you are taking
- any samples asked for in your appointment letter
- a list of questions you may want to ask
Cancelling your appointment
It’s quick and easy to cancel your appointment. If you give us warning, we can give it to someone else who really needs it. We’d also be happy to rearrange your appointment to a more convenient time. You can phone the clinic number on your a appointment letter to arrange this.
- if you are unable to attend your second appointment you will be discharged back to the care of your GP
- if you fail to contact us to re-arrange your appointment and you do not attend, we may discharge you back to the care of your GP
- we try to keep every appointment we make, but medical emergencies and unforeseen circumstances mean that we sometimes have to cancel appointments
Cancellations by us
If this happens we are sorry for any inconvenience caused and will arrange a new appointment for you as soon as possible.
When you arrive please report to the Bryning reception area where you will be greeted by one of our receptionists who will check your details and book you in. Patients are seen in the order of appointment time (not on a first-come-first-served-basis).
Every effort is made for you to be seen at your appointed time, but there may be occasions when delays occur. Please allow up to two - three hours for your appointment.
If you find that you are unable to wait for your appointment, the reception team will be able to make another appointment for you at your request.
Each clinic is staffed by a consultant or a nurse lead specialist who is in charge of patient care, and a team of doctors, nurses, therapists and nursing assistants. Your appointment may not be with the consultant but with one of the doctors or nurses within the team.
When you see the clinician they are likely to ask you questions about your medical history and may need to perform an examination. If the clinician is of the opposite sex a nursing assistant will be available to chaperone during your examination.
The clinician may decide that you need further investigations and tests on the day of your appointment. If so, a member of the nursing team will direct you to the relevant department and give you the appropriate form to hand in.
Investigations on the day of your appointment will vary from patient to patient. These are some of the most common:
- blood test – a blood test is a very common and routine procedure. A sample of your blood is taken so we can look for any abnormalities. The sample is then sent to the laboratory to be analysed. A ticket system is used within the blood test area, so patients are seen in the order they arrive
- X-rays – an x-ray is a painless test to obtain an image of a part of your body.
- urine sample – a urine sample is a very common and routine procedure. The doctor may ask for a sample to help them diagnose or rule out health conditions. The nursing assistant will give you a container and explain to you how to collect the urine sample
When you leave the team will inform you if you require a follow up appointment at a later date to review any investigations that may have taken place, or for ongoing treatment. You will be able to book this appointment at the reception before you leave.
Carers support specialist
What does the carers' support specialist do?
Liaises on your behalf with hospital staff, social services and voluntary services; provides carers with relevant information, eg support services available in and out of hospital; recognises carer's expertise by listening to your concerns and responding appropriately; considers carer's health and wellbeing; provides emotional support for carers; ensures that you understand what's happening with the person you care for whilst they are in hospital and with their discharge.
Are you a carer?
A carer is someone who is responsible without payment for the well being of another person. They may be a friend, family member or neighbour.Being a carer can be hard work, cause isolation, worry and financial pressure. It's important to take into account the carer's own health and wellbeing, and hence the importance of the carer's assessment. It is important to know that you are a carer to make sure that you are receiving all the support you are entitled to eg practical, emotional and financial.
What is a carer's assessment?
A carer's assessment is a checklist to help you think about the tasks you perform as part of your caring role. It gives you the opportunity to express any difficulties that you may have. It helps us plan the care needs of the person you look after and enables a smooth discharge from hopsital taking into account your needs as well as theirs.
How can the carers' support specialist help you?
- liaise and provide support with other professionals involved in their care
- help with any questions you may have
- attend case conferences and multi-disciplinary meetings
- discuss respite care
- provide information about benefits
- help with complex cases
- help with discharge planning and social service referrals.
Carers Support Specialist.
020 8510 8817
Elderly Care inpatient unit
The Elderly Care Unit (ECU) is a 56 bed acute short stay ward for patients over 65 years old. We use a mixture of acute medical care and rehabilitation to ensure the needs of each patient are individually met through a multidisciplinary approach. From this unit patients will either be transferred to a ward or be discharged.
The team on ECU includes:
- three medical teams led by consultants specialising in care for older people
- nursing assistants
- occupational therapists
- speech and language therapists
- social workers and discharge facilitator
- carers support specialist.
Therapy assessment and interventions for patients enable patients to become more independent and facilitate earlier discharges. This therapy aids in the recovery process and thus reduces the time spent in hospital.
The team work closely together to ensure the safest possible discharge. This is achieved by referring to internal or external agencies/services, organising/recommending appropriate equipment and making other recommendations to maximise safety on discharge.
Mary Seacole Nursing Home
Qualified registered nurses and health care support workers are responsible for the day-to-day care of all our residents.
- long term conditions
- end of life/pallative care
- care for people with some degree of dementia
- stroke with severe disability
- multiple sclerosis (end stage)
- progressive supranuclear palsy with reduced mobility
- paraplegic/quadraplegic due to trauma
- end stage renal/heart failure
Shared areas include dining room, lounges and activity rooms including a cinema experience area for a variety of physical activities. In addition there are private gardens including two landscaped garden areas and paved terraces for residents and staff where residents can sit in the warmer weather.
The accommodation for people who use services is arranged in three wings on the ground and first floor. Facilities for food preparation and storage of medical equipment, laundry and office space is also provided within the nursing home.
The second floor is used as office space, including the office base for the Homerton Continuing Care At Home team.
Accomodation consists of a single furnished room with en-suite bathroom, which residents are encouraged to personalise. The building is fully accessible to people with disabilities with access to the first and second floor levels provided via lifts as well as stairs. Entry to the building is controlled by video and audio entryphone operated doors.
Referrals to the home are made via the Continuing Care panel. The respite service consists of seven beds. These enable older people to take a break away from home in relaxing surroundings.
Eligibility for respite is decided after an initial home visit is done by the respite care coordinator or team leader. Referrals are made via GPs, care managers, social workers, carers' liaison nurse and families.
Roy Tecson Matron
tel: 020 7739 5506
Jenette Gilarty (senior staff nurse – ground floor)
tel: ground floor 020 7739 7977 / first floor 020 7739 5143
39 Nuttall Street
London, N1 5LZ
tel: 020 7739 7977
Parkinson's and movement disorders
We specialise in a wide range of disorders of movement including:
- Tremors (eg Parkinson’s disease, Essential tremor)
- Dystonia (eg writer’s cramp, musician’s dystonia, torticollis, generalised dystonia)
- Slowing of movement/walking difficulty (eg Parkinson’s disease, cerebellar ataxia)
- Intermittent muscle jerks (eg tics, adult Tourette’s, myoclonus)
- Genetic conditions (eg Huntington’s disease)
- People with dementias with an associated movement disorder (eg Dementia with Lewy Bodies)
Who should be referred to the clinic?
- Patients with suspected or established Parkinson's disease
- Patients with tremor
- Patients with any other involuntary movements (suspected or established)
How can I be referred to this service?
- Patients are initially seen in the Parkinson's disease and movement disorders clinic at Homerton University Hospital after referral by their GP or a hospital doctor
- Referrals should be addressed to Dr Ashwani Jha at the Bryning Unit (see contact details)
- Referrals in the community can be accessed by Choose and Book under 'Movement Disorder Clinic' in the Elderly Care section
Where and when is the clinic held?
- The clinic runs in the Bryning day unit at Homerton University Hospital on Wednesday mornings.
- Patients will normally need to allocate an entire morning to attending the clinic because they may be assessed by a number of doctors and other clinical specialists, and they will be provided with lunch if necessary.
- Transport can be provided where required.
Who will I see in the clinic?
You will be assessed by a doctor who specialises in the treatment of Parkinson's disease and movement disorders, or a member of their clinical team.
You may also be seen by a therapist, including a physiotherapist, occupational therapists, and/or speech and language therapists as required. A Parkinson's disease specialist practitioner is also available in the clinic.
Which tests are available through the clinic?
After a clinical assessment, you may be asked to undergo some tests including:
- Postural blood pressure measurements
- Brain scans (MRI or CT)
- Dopamine transporter scans (DAT scan)
- L-Dopa or Apomorphine challenge tests
- Neuropsychological testing
- Genetic tests
Which treatments are available within the clinic?
We offer a comprehensive range of treatments including:
- A wide range of medications for Parkinson’s and other movement disorders. These are usually oral medications taken daily and regularly re-prescribed by your GP.
- Personalised physiotherapy, occupational therapy and speech therapy with movement disorder specialist clinicians.
- A Parkinson's disease education group is run by staff for educating patients about Parkinson's disease.
- Access and sign-posting to exercise groups including the Parkinson’s specific exercise groups.
- Access to specialist assessment for advanced therapies such as Deep Brain Stimulation (DBS) surgery and Apomorphine pumps in conjunction with staff at the National Hospital for Neurology and Neurosurgery in Queen Square.
The key clinic staff are:
- Dr Ashwani Jha: Service Lead, Consultant Neurologist and Movement Disorder specialist
- Dr Corrinne Quah: Inpatient Lead, Consultant Elderly Care physician and Parkinson’s Disease specialist
- Kira Rowsell: Parkinson’s Specialist Clinician
Other members of the integrated therapy team
- Anna Walsh,Tim Reynolds: Out-of-borough therapists for the Bryning Unit
- Toni Fairey, Rosie Humphreys, Fiona Johnson, Tom Bennett: Therapists from Adult Community Rehabilitation Team
- Sanjay Sunak: Principal Clinical Neuropsychologist
Referrals and written queries should be addressed (ideally via email) to our clinicians who are based at:
Homerton Healthcare NHS Foundation Trust
London E9 6SR.
tel: 020 8510 8941/8048
email: huh-tr.Parkinsonsservice@nhs.net (for GP referrals and non-urgent queries only, checked weekly by medical team)