Rehabilitation & Recovery
Everything you need to know about rehabilitation after surgery, stroke, or injury—including why home-visit physiotherapy may be your best option when NHS waiting times stretch to months.
Key Takeaways
- NHS physiotherapy waits now average 13–24 weeks in many areas, while private physiotherapy typically offers same-day or next-day appointments
- Cochrane-level evidence confirms home-based rehabilitation produces outcomes equivalent to clinic-based care for cardiac, knee replacement, and stroke recovery
- Over 20 million UK adults have a musculoskeletal condition, accounting for 30% of GP consultations
- Home-visit physiotherapy offers distinct advantages for elderly, post-surgical, and mobility-limited patients—including assessment in your actual living environment
Outpatient rehabilitation physiotherapy helps you recover from surgery, injury, or illness through expert-guided exercise, manual therapy, and education—without requiring a hospital stay. At CK Physiotherapy in West London, our Chartered Physiotherapists deliver rehabilitation programmes both in our Hanwell clinic and through home visits across Ealing, Acton, Chiswick, and surrounding areas.
If you're facing weeks or months on an NHS waiting list—or you've been discharged from hospital with a recommendation for physiotherapy—this guide explains your options. We'll cover what outpatient rehabilitation involves, the clinical evidence supporting different approaches, realistic recovery timelines, and why home-visit physiotherapy may be the right choice for your circumstances.
The need has never been greater. The NHS waiting list stood at 7.29 million cases as of December 2025, with the median waiting time rising to 13.4 weeks—up sharply from the pre-COVID baseline of 8.3 weeks. For many people, particularly those recovering from joint replacement surgery or stroke, this delay can significantly impact outcomes.
What Is Outpatient Rehabilitation Physiotherapy?
Outpatient rehabilitation physiotherapy is structured treatment delivered outside a hospital setting—either at a physiotherapy clinic or in your own home—designed to restore function, reduce pain, and help you return to your normal activities after surgery, injury, or illness.
Unlike inpatient rehabilitation (where you stay in hospital), outpatient physiotherapy allows you to live at home while attending regular sessions. This approach is recommended by NICE guidelines for most people recovering from hip and knee replacement, cardiac events, stroke, and musculoskeletal conditions.
A typical outpatient rehabilitation programme includes:
- Comprehensive assessment: Your physiotherapist evaluates your current function, pain levels, range of motion, strength, and specific goals
- Personalised exercise prescription: Targeted exercises to rebuild strength, flexibility, and endurance—progressed as you improve
- Manual therapy: Hands-on techniques to mobilise joints, release tight muscles, and reduce pain
- Education and self-management: Understanding your condition and learning how to manage it independently
- Functional training: Practising specific movements and activities relevant to your daily life or work
At CK Physiotherapy, we combine evidence-based physiotherapy techniques with advanced treatments like shockwave therapy and electrotherapy when clinically appropriate, always tailored to your individual needs and recovery goals.
How Long Are NHS Physiotherapy Waiting Times?
NHS physiotherapy waiting times vary significantly by region, but Freedom of Information requests reveal average routine waits of 45 days nationally—with some London sites reporting MSK physiotherapy waits of 24 weeks as of May 2025.
The broader NHS picture provides important context. Only 62% of patients were seen within the 18-week constitutional standard by October 2025, far below the 92% target last met in September 2015. The government has pledged to restore that standard by March 2029.
For rehabilitation specifically, the gap between what's recommended and what's available can be stark:
| Factor | NHS Physiotherapy | Private Physiotherapy |
|---|---|---|
| Waiting time | Typically 6–24 weeks | Same-day or next-day |
| Session length | 20–40 minutes | 30–60 minutes |
| Continuity of care | Often see different clinicians | Same physiotherapist throughout |
| Hands-on treatment time | Limited | Comprehensive |
| Home visits | Very limited availability | Often available |
| Cost | Free at point of use | £60–£120 per session (London) |
Research published in 2025 found that private providers deliver hip and knee replacements with waiting times roughly half those of the NHS. The UK physiotherapy market reflects this demand—valued at £1.38 billion in 2022 and projected to reach £1.87 billion by 2030, with demand for physiotherapists growing 7% in 2024 alone.
This isn't about NHS versus private as a binary choice. For many people, the ideal approach combines both: using private physiotherapy to begin rehabilitation promptly while NHS services catch up, or supplementing NHS provision when more intensive support is needed.
What Conditions Benefit from Outpatient Rehabilitation?
Musculoskeletal conditions dominate outpatient physiotherapy, with 20.3 million UK adults affected—accounting for up to 30% of GP consultations and over 30 million lost working days annually. However, outpatient rehabilitation also plays a crucial role in recovery from surgery, stroke, cardiac events, and neurological conditions.
Hip and Knee Replacement Rehabilitation
The National Joint Registry recorded 263,865 joint procedures in calendar year 2024. If you're among the 78,000 people having hip replacement or 96,000 having knee replacement in England each year, NICE guideline NG157 recommends:
- Rehabilitation beginning on the day of surgery or within 24 hours
- Early mobilisation with hospital stays typically 1–3 days
- Self-directed rehabilitation as first line for uncomplicated cases
- Supervised outpatient rehabilitation for those with ongoing functional difficulties
Recovery timeline: Full recovery typically takes 6–12 months for hip replacement and 6–18 months for knee replacement. Most people return to light activities within 6 weeks and driving at 6–8 weeks (always check with your surgeon).
Stroke Rehabilitation
Stroke affects approximately 100,000 people per year in the UK. The landmark NICE guideline NG236 (October 2023) significantly increased the recommended rehabilitation intensity to at least 3 hours per day on 5 days per week—a major increase from the previous 45-minute minimum per therapy type.
Early Supported Discharge (ESD) programmes reduce hospital stays by approximately 5 days and death or dependency by 5 fewer adverse outcomes per 100 patients. However, only 35% of survivors currently receive a 6-month review—a declining trend—and only 17% of community stroke services have appropriate access to all core rehabilitation disciplines.
Cardiac Rehabilitation
Cardiac rehabilitation follows four phases:
- Phase 1: Acute inpatient care
- Phase 2: Early post-discharge (1–6 weeks)
- Phase 3: Structured exercise programme (4–12 weeks of supervised sessions)
- Phase 4: Long-term community maintenance
Currently, cardiac rehabilitation uptake has plateaued at roughly 50% against an NHS Long Term Plan target of 85% by 2028. Scaling to this target would prevent an estimated 50,000 premature deaths and 140,000 acute admissions over 10 years.
Falls Prevention for Older Adults
Falls affect 30% of over-65s and 50% of over-80s annually, costing the NHS approximately £2.45 billion per year. NICE guideline CG161 recommends multifactorial risk assessment for all at-risk over-65s, with exercise programmes combining balance and strength training shown to reduce fall rates by up to 30%.
The Otago Exercise Programme—a physiotherapist-delivered, home-based protocol—has established evidence for community-dwelling elderly people. This is precisely the type of rehabilitation where home-visit physiotherapy offers significant advantages.
Musculoskeletal Conditions
The top conditions by volume include:
- Low back pain: 28.5% one-month prevalence in UK adults, costing the economy an estimated £15.84 billion per year
- Osteoarthritis: 8.75 million people aged 45+ have sought treatment; knee OA prevalence of 18% in over-45s
- Neck pain, shoulder injuries, and tendinopathies
- Sciatica: Often responds well to targeted physiotherapy
- Chronic pain: Affects one-third to one-half of UK adults
Is Home-Based Rehabilitation as Effective as Clinic-Based Care?
Yes—multiple Cochrane systematic reviews confirm that home-based physiotherapy produces outcomes equivalent to clinic-based care for cardiac rehabilitation, knee replacement, and stroke recovery. This is one of the most well-evidenced findings in rehabilitation medicine.
What the Research Shows
Cardiac rehabilitation: A 2023 Cochrane review (24 RCTs, 3,046 participants) found no consistent evidence of differences between home-based and centre-based cardiac rehabilitation for exercise capacity, risk factors, quality of life, or cardiac events.
Knee replacement: A JAMA Network Open meta-analysis (5 studies, 752 participants) found no clinically important difference between clinic-based and home-based rehabilitation for mobility, pain, or function. The conclusion: "Home-based rehabilitation is an appropriate first line of therapy after uncomplicated TKA."
Stroke: The Cochrane Early Supported Discharge review (16 trials, 2,161 patients) demonstrated that coordinated home-based discharge services reduce hospital stays by ~5 days while improving outcomes, with patients reporting higher satisfaction and less depression.
Why Home-Visit Physiotherapy Often Works Better
For many patients—particularly elderly people, those with mobility limitations, or those recovering from surgery—home-visit physiotherapy offers distinct advantages that can actually improve outcomes:
- Functional assessment in your real environment: Your physiotherapist can identify trip hazards, assess bathroom safety, evaluate stair access, and tailor exercises to your actual home conditions
- No transport barriers: Eliminates the fatigue, pain, and fall risks associated with travelling to appointments
- Familiar surroundings: Particularly important for those with cognitive impairment or anxiety
- Better attendance rates: Individual home sessions show better attendance than group clinic sessions
- Family involvement: Carers and family members can observe and learn how to support your exercises
NHS policy increasingly recognises this. The NHS Intermediate Care Framework (September 2023) established a "home first" approach as the organising principle for rehabilitation services. At CK Physiotherapy, we've offered home-visit physiotherapy across West London since 2003—long before the evidence became mainstream.
Your Journey from Hospital Discharge to Full Recovery
Understanding what happens after hospital discharge—and where gaps typically occur—helps you plan your rehabilitation effectively.
The NHS Discharge Pathway
When you're discharged from hospital, you'll typically follow one of four pathways:
- Pathway 0: Simple discharge, no support needed
- Pathway 1: Home with up to 6 weeks of support
- Pathway 2: Community rehabilitation unit
- Pathway 3: Care home
The Community Independence Service provides intermediate care for up to 6 weeks. After this period, patients needing ongoing rehabilitation face a significant gap—full recovery from hip replacement takes 6–12 months, knee replacement 6–18 months, and stroke rehabilitation is often measured in years.
Where Private Physiotherapy Fills the Gap
This is precisely where private outpatient rehabilitation—whether clinic-based or home-visit—becomes valuable. At CK Physiotherapy, we commonly support patients who:
- Have been discharged from hospital with "physiotherapy recommended" but face weeks or months on NHS waiting lists
- Have completed their 6-week NHS community rehabilitation but aren't yet at full function
- Want to begin rehabilitation immediately post-surgery to optimise outcomes
- Need more intensive support than NHS provision allows—longer sessions, more frequent appointments, or one-to-one attention
- Prefer the convenience and personalisation of home-visit physiotherapy
Important: Private physiotherapy complements NHS care—it doesn't replace it. If you're waiting for NHS physiotherapy, starting private treatment won't affect your NHS appointment. Many of our patients at CK Physiotherapy use both, depending on their needs and circumstances.
Outpatient Rehabilitation in West London
Ealing borough's demographics make access to rehabilitation services particularly important—and challenging. With approximately 370,000 residents (the 3rd most populous London borough), the 65+ population has grown 22.8% between 2011 and 2021 and is projected to grow by a further 50% by 2041.
Healthy life expectancy for males in Ealing is just 62.7 years, meaning an average of 18.4 years living with long-term health conditions requiring rehabilitation support. By 2043, an estimated 4.5 million people aged 65+ will live alone nationally—intensifying demand for home-based services.
Local Hospital Discharge and Rehabilitation
If you're discharged from Ealing Hospital, West Middlesex University Hospital, Hillingdon Hospital, or Charing Cross Hospital (which hosts the specialist neurological rehabilitation unit), you may find that NHS community rehabilitation services are stretched. CK Physiotherapy serves patients across the W7, W5, W13, UB1, UB2, TW8, and W4 postcodes—offering home visits where clinic attendance is difficult and same-day appointments when NHS waits would delay your recovery.
The North West London Integrated Care System's Joint Forward Plan emphasises moving care closer to home and reducing hospital admissions. Home-visit physiotherapy aligns directly with this strategic direction, providing expert rehabilitation in patients' own environments while reducing pressure on NHS community services.
Frequently Asked Questions
How long does outpatient physiotherapy rehabilitation take?
The duration depends on your condition and goals. A standard course averages 5–6 sessions for straightforward musculoskeletal issues. Post-surgical rehabilitation typically requires 8–12 sessions over 3–6 months. Stroke and complex neurological rehabilitation may continue for 12 months or longer. Your physiotherapist will discuss realistic timelines during your initial assessment.
What's the difference between rehabilitation and standard physiotherapy?
Rehabilitation physiotherapy is a structured programme focused on restoring function after surgery, injury, or illness—typically involving regular appointments over weeks or months with progressive goals. Standard physiotherapy may address acute pain or injury with fewer sessions. Many patients at CK Physiotherapy benefit from both approaches at different times.
Will home-visit physiotherapy be as effective without gym equipment?
Research consistently shows home-based rehabilitation produces equivalent outcomes to clinic-based care. Effective rehabilitation depends more on exercise adherence and progression than access to gym equipment. Your physiotherapist will prescribe exercises using your body weight, resistance bands, and household items—and can assess your actual home environment to make exercises more relevant and safer.
How much does private outpatient rehabilitation cost?
Private physiotherapy in London typically ranges from £75–£150 for an initial assessment and £60–£120 for follow-up sessions. Home visits may carry a small additional fee. Many health insurance policies cover physiotherapy—check with your provider. At CK Physiotherapy, we're registered with major insurers including BUPA and AXA PPP.
When should I start rehabilitation after surgery?
NICE guidelines recommend beginning rehabilitation on the day of surgery or within 24 hours for joint replacement. The earlier you start appropriate exercises, the better your outcomes tend to be. If you're facing a long NHS wait, beginning private physiotherapy promptly—even while waiting for NHS services—can significantly improve your recovery trajectory.
Can I have NHS and private physiotherapy at the same time?
Yes. Private physiotherapy doesn't affect your NHS entitlement. Many patients use private services to start treatment quickly or supplement NHS provision, then transition to NHS-only care as their needs decrease. We're happy to communicate with your NHS physiotherapist to ensure coordinated care.
Do I need a GP referral for private physiotherapy?
No GP referral is needed for private physiotherapy. You can book directly with CK Physiotherapy. However, some insurance policies require GP referral for reimbursement—check your policy terms. If you've been discharged from hospital with a physiotherapy recommendation, that serves as sufficient clinical indication.
What qualifications should I look for in a rehabilitation physiotherapist?
All physiotherapists in the UK must be registered with the Health and Care Professions Council (HCPC). Look for membership of the Chartered Society of Physiotherapy (CSP), which indicates additional professional standards. For post-surgical rehabilitation, experience with your specific procedure is valuable. All physiotherapists at CK Physiotherapy are HCPC registered and CSP members.
Ready to Start Your Rehabilitation?
Whether you're recovering from surgery, managing a chronic condition, or supporting an elderly parent, CK Physiotherapy offers expert rehabilitation in our Hanwell clinic or at your home across West London.
Same-day appointments available • Home visits across W5, W7, W13, W4, UB1, UB2, TW8
References & Further Reading
- NHS England (2026). Consultant-led Referral to Treatment Waiting Times. NHS England Statistics.
- House of Commons Library (2026). NHS key statistics: England. Research Briefing CBP-7281.
- National Institute for Health and Care Excellence (2020). Joint replacement (primary): hip, knee and shoulder [NG157]. NICE Guidelines.
- Anderson L, et al. (2023). Home-based versus centre-based cardiac rehabilitation. Cochrane Database of Systematic Reviews. DOI: 10.1002/14651858.CD007130.pub5
- National Institute for Health and Care Excellence (2023). Stroke rehabilitation in adults [NG236]. NICE Guidelines.
- National Institute for Health and Care Excellence (2013). Falls in older people: assessing risk and prevention [CG161]. NICE Guidelines.
- British Medical Association (2026). NHS backlog data analysis. BMA Pressures Analysis.
- Chartered Society of Physiotherapy (2023). Rehabilitation: the missing link. CSP Policy Report.
- National Joint Registry (2025). National Joint Registry Annual Report 2025. NJR Centre.
- NHS England (2023). Intermediate Care Framework for Rehabilitation, Reablement and Recovery.
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