The Rehabilitation Co-ordinator acts as the Single Point of Contact
(SPOC) for referrals into the Cheshire and Merseyside Rehabilitation
Network, providing expert clinical advice and coordination for patients
with complex rehabilitation needs. Key responsibilities include
reviewing and triaging referrals, undertaking comprehensive
assessments, advising on the most appropriate rehabilitation pathway,
and coordinating access to specialist rehabilitation services across the
Network. The post holder works closely with acute hospital teams,
rehabilitation units, community services, patients, families, and carers
to facilitate timely transfers and ensure seamless transitions
throughout the rehabilitation journey. The role involves supporting
complex discharge planning, monitoring patient progress through
rehabilitation pathways, maintaining referral and activity databases,
and ensuring key performance indicators relating to access, waiting
times, and patient flow are achieved. The post holder also provides
specialist rehabilitation advice to healthcare professionals, contributes
to service development and quality improvement initiatives, and
supports the Network's aim of delivering equitable access to highquality rehabilitation services across Cheshire and Merseyside.
The Rehabilitation Co-ordinator will act as the Single Point of Contact (for referrals , supporting patients with complex rehabilitation needs to
access the most appropriate service.
Key responsibilities include reviewing and triaging referrals, undertaking assessments, providing specialist rehabilitation advice, and coordinating
access to rehabilitation services across the Network.
Working closely with acute hospitals, rehabilitation units, community services, social care teams, patients and carers, the post holder will facilitate
timely transfers, support discharge planning, and reduce delays in rehabilitation pathways. They will monitor patients awaiting transfer, identify
barriers to progression, and escalate concerns as required.
The role includes participation in multidisciplinary meetings, complex case discussions, stakeholder engagement, and providing advice on
rehabilitation pathways.
The successful candidate will contribute to service development, quality improvement, audit activity, and delivery of regional rehabilitation
priorities. They will maintain accurate records, monitor patient pathways, support performance reporting, and contribute to objectives relating to
patient flow, waiting times, access, and outcomes.
Working autonomously, the post holder will use advanced clinical reasoning and professional judgement to support equitable access to
rehabilitation services and improve patient outcomes. Regular travel across Cheshire and Merseyside will be required.
The Walton Centre NHS Foundation Trust is the only NHS trust to hold dual accreditation for the Investors in People. We invest in people and we invest in wellbeing standards and have been awarded Gold status for both. The Walton Centre is a leader in the treatment and care of neurology and neurosurgery, placing the patient and their family at the heart of everything we do. As the only specialist hospital trust in the UK dedicated to providing comprehensive neurology, neurosurgery, spinal and pain management services we are proud to be rated as an Outstanding Trust by the Care Quality Commission (CQC), and champion change throughout the field of neuroscience. Originally formed in 1992, the Trust received Foundation Trust status in 2009.
With around 1,450 staff, The Walton Centre treats more than 127,000 outpatients and 18,000 inpatients each year. We have leading specialists and incredibly dedicated staff delivering excellent clinical outcomes for brain, spinal and neurological care nationally and internationally. Teams across our site in Fazakerley, Liverpool, offer a world-class service in diagnosing and treating injuries and illnesses affecting the brain, spine and peripheral nerves and muscles, and in supporting people suffering from a wide range of long-term neurological conditions.
The Rehabilitation Co-ordinator will be a key member of the Cheshire and Merseyside Rehabilitation Network Co-ordination Service, acting as the
Single Point of Contact (SPOC) for referrals into the Network and supporting the delivery of high-quality, patient-centred rehabilitation pathways
across Cheshire and Merseyside.
The post holder will provide expert clinical leadership and coordination for patients with complex rehabilitation needs, ensuring timely access to
the most appropriate rehabilitation service and facilitating smooth transitions between acute, rehabilitation, community, and social care settings.
Clinical Responsibilities
- Receive, review, triage, and manage referrals received by the Cheshire and Merseyside Rehabilitation Network.
- Undertake comprehensive assessments of patients with complex rehabilitation needs using referral documentation, clinical records, virtual
assessments, and discussions with multidisciplinary teams.
- Utilise advanced clinical reasoning and specialist rehabilitation knowledge to determine the most appropriate rehabilitation pathway.
- Provide specialist advice and guidance to referring teams regarding rehabilitation needs, rehabilitation potential, service eligibility, and
available rehabilitation pathways.
- Support patients and families throughout the rehabilitation journey, ensuring they are informed and involved in decision-making wherever
appropriate.
- Monitor patients awaiting transfer to rehabilitation services and identify actions required to facilitate progression through the pathway. Escalate clinical concerns or barriers to rehabilitation in a timely manner to appropriate clinicians and managers. Care Co-ordination and Patient Flow
- Coordinate access to specialist rehabilitation services across the Cheshire and Merseyside Rehabilitation Network.
- Facilitate timely transfers between acute hospitals, specialist rehabilitation units, community rehabilitation services, and discharge
destinations.
- Work collaboratively with multidisciplinary teams to support safe, effective, and timely discharge planning.
- Identify and address delays affecting patient flow and access to rehabilitation services.
- Contribute to reducing unnecessary hospital length of stay and improving utilisation of rehabilitation resources across the system.
- Support delivery of the Network's objectives in relation to equitable access, patient flow, and rehabilitation outcomes.
Communication and Partnership Working
- Act as the primary point of contact for referrers, patients, families, carers, and rehabilitation providers.
- Establish and maintain effective working relationships with stakeholders across acute hospitals, rehabilitation units, community services,
Integrated Care Boards, local authorities, and third-sector organisations.
- Participate in multidisciplinary meetings, case conferences, discharge planning meetings, and service development forums.
- Provide professional advice, support, and education regarding rehabilitation pathways and Network processes.
- Manage sensitive and complex conversations with patients, families, and professionals regarding rehabilitation options, expectations, and
service provision.
Service Development and Quality Improvement
- Contribute to the ongoing development and improvement of rehabilitation pathways across Cheshire and Merseyside.
- Participate in audits, service evaluations, quality improvement projects, and implementation of national and regional rehabilitation initiatives.
- Support the delivery of recommendations arising from NHS England rehabilitation reviews and Integrated Care Board priorities.
- Identify opportunities to improve patient experience, service efficiency, and rehabilitation outcomes.
Information Management and Performance Monitoring
- Maintain accurate and contemporaneous records relating to referrals, assessments, patient activity, and pathway progression.
- Ensure data quality and compliance with information governance requirements.
- Monitor and report on key performance indicators including referral activity, waiting times, lengths of stay, transfer delays, and rehabilitation
outcomes.
- Produce reports and information to support operational management, service planning, capacity management, and performance reporting.
Leadership and Professional Responsibilities
- Work autonomously within professional scope of practice, exercising advanced clinical judgement and decision-making.
- Provide professional leadership within the Rehabilitation Co-ordination Service and promote best practice in rehabilitation pathway
management.
- Maintain professional registration and comply with relevant professional standards, Trust policies, and governance requirements.
- Participate in supervision, appraisal, mandatory training, and continuing professional development activities.
- Contribute to the education and development of colleagues and wider healthcare teams where appropriate.
Key Outcomes
The post holder will contribute to:
- Improving patient flow across acute, rehabilitation, and community services.
- Reducing delays in access to rehabilitation and discharge from hospital.
- Ensuring patients receive the right rehabilitation intervention at the right time and in the right setting.
- Supporting delivery of regional rehabilitation transformation programmes.
- Improving patient experience and rehabilitation outcomes.
- Optimising use of specialist rehabilitation resources across Cheshire and Merseyside.
- Supporting achievement of local, regional, and national performance objectives relating to rehabilitation, discharge, and system flow
