Neurological Rehabilitation · West London
Medically reviewed by Bryan Kelly, Chartered Physiotherapist (HCPC-registered) · Last updated: September 2026 · 12 min read
This guide is written for stroke survivors, carers and family members in Hanwell, Ealing and the wider West London area. It sets out what the current UK guidelines recommend, what the evidence says physiotherapy can (and cannot) do, and how a private clinic like CK Physio can sit alongside your NHS team rather than replace it. Every clinical statement is anchored to a named UK source — primarily the Stroke Association, NICE, and the National Clinical Guideline for Stroke.
Key takeaways
If you or someone you love has recently had a stroke, you are almost certainly juggling two feelings at once: relief that they survived, and worry about what comes next. That worry is understandable. Recovery from a stroke is rarely a straight line, and the amount of therapy someone actually receives on the NHS can vary considerably from area to area.
Stroke in the UK
Stroke strikes every five minutes. Around 100,000 people have a stroke each year. There are 1.4 million stroke survivors in the UK today.
Source: Stroke Association, Stroke statistics.
A stroke happens when the blood supply to part of the brain is interrupted, either by a clot (an ischaemic stroke) or a bleed (a haemorrhagic stroke). Brain cells starved of oxygen begin to die within minutes, which is why the FAST message — Face, Arm, Speech, Time to call 999 — is so important.
The good news, and it is genuinely good news, is that the brain does not stop learning after a stroke. Through a process called neuroplasticity, undamaged areas can, with practice, take on functions that were previously handled elsewhere. This is the foundation of everything a stroke physiotherapist does.
Understanding the NHS stroke pathway helps you know where you are, and where a private clinic like ours can add value. For most patients in Hanwell, Ealing and the surrounding W5, W7 and W13 postcodes, the journey looks something like this:
Private physiotherapy is not a substitute for any of these steps. Where it can help is in filling the gaps: topping up therapy intensity toward the levels the guidelines now recommend, continuing rehabilitation after NHS discharge, and delivering sessions in your own home when travel is difficult. To learn more about our clinic-based service, see our physiotherapy treatments page and our West London location page.
Two major national documents set the standard for stroke rehabilitation in the UK today. Both were published in 2023, and both represent a step change from the guidance that preceded them.
The National Institute for Health and Care Excellence updated its stroke rehabilitation guideline in October 2023. Its headline recommendation (1.2.16) is that adults after a stroke should be offered "needs-based rehabilitation … for at least 3 hours a day, on at least 5 days of the week, and cover a range of multidisciplinary therapy including physiotherapy, occupational therapy and speech and language therapy." This is roughly a fourfold increase on the previous 2013 standard of 45 minutes of each therapy per day, and it formally endorses telerehabilitation as a legitimate way to deliver some of that care.
Published by the Intercollegiate Stroke Working Party and endorsed by the Royal College of Physicians, SIGN and the Royal College of Physicians of Ireland, the 2023 National Clinical Guideline for Stroke made two shifts that matter enormously to families:
The intensity reality gap
The Sentinel Stroke National Audit Programme (SSNAP), which monitors stroke care across England, Wales and Northern Ireland, has consistently found that patients receive less therapy than the guidelines recommend. This is one of the reasons families in West London sometimes choose to top up NHS therapy with private sessions.
A well-run stroke rehabilitation programme is not a single technique but a personalised blend of approaches. Here are the ones with the strongest evidence base — the ones a Chartered Physiotherapist working in neurological rehabilitation is most likely to draw on.
The principal approach recommended by the 2023 National Clinical Guideline. Rather than exercising in the abstract, you practise the specific things you want to get back to — standing from a chair, reaching for a cup, walking to the front door — in a graded, repeated way. Progress is measured in what you can now do that you could not do last week.
For people who have some movement in a weaker arm but tend not to use it, CIMT restrains the stronger arm for periods of the day to encourage use of the weaker one. A 2015 Cochrane review of 42 studies involving 1,453 participants found CIMT was associated with meaningful gains in arm motor function, though the carry-over to everyday activities was more modest and highly individual.
Walking again is one of the most common goals stroke survivors bring to us. Rehabilitation may include treadmill work, over-ground practice, balance drills, and, where appropriate, orthoses or walking aids. The emphasis is on quality and safety, not just distance.
NICE supports the use of FES for drop foot of central neurological origin, and the 2023 NG236 guideline recommends considering neuromuscular electrical stimulation for focal spasticity and shoulder pain after stroke. The evidence base is supportive rather than dramatic — it is best thought of as a useful adjunct rather than a standalone treatment. You can read more on our electrotherapy page.
Emerging evidence suggests mirror therapy and virtual-reality-based programmes may help upper-limb recovery, particularly when combined with conventional rehabilitation. We treat these as promising adjuncts rather than proven replacements for hands-on physiotherapy.
Endorsed by both NICE NG236 and the National Clinical Guideline, remote sessions have become a normal part of stroke rehabilitation since 2020. They can work well for people who cannot easily travel and for topping up between in-person sessions.
For a broader look at how neurological rehabilitation is delivered privately, our related guide on common questions about neurological physiotherapy treatment is a helpful next read.
Direct answer: The most rapid gains typically happen in the first weeks and months after a stroke, with meaningful improvement often continuing for 12 to 18 months, and sometimes years, thanks to neuroplasticity. Full recovery cannot be predicted or guaranteed — every stroke is different — but improvement is possible far later than many people are told.
The recovery curve tends to be steepest in the first three to six months after a stroke, which is why early, intensive rehabilitation matters so much. But it is a mistake to think of six months as a hard ceiling. The NHS, the Stroke Association and the 2023 National Clinical Guideline are all clear that improvement can continue well beyond that point, provided the practice continues.
Practically, this means that if progress has slowed with NHS input and you or a loved one has been discharged, this is not necessarily the end of the road. Many of the survivors we see at CK Physio come to us six, twelve or eighteen months post-stroke, and continue to make measurable gains.
Direct answer: Yes. Home-based physiotherapy is a well-established option for stroke survivors, particularly after hospital discharge or when travel is difficult. It is endorsed within the current UK stroke pathway (Early Supported Discharge is delivered at home), and private home-visit physiotherapy can extend that model further into recovery.
For many of our West London patients, a home visit is the difference between doing rehabilitation and not doing it at all. Practising in your own kitchen, on your own stairs, using your own furniture, is often more relevant than practising in a clinic. It also removes the fatigue of travel — which, after a stroke, can be considerable.
We serve Hanwell, Ealing, Northfields, Greenford, Brentford, Southall, Perivale, Acton, Isleworth and Chiswick from our Hanwell base. Our full home visit physiotherapy guide covers costs, what happens in a first appointment, and how to prepare.
Private physiotherapy in London typically runs from around £65 for a follow-up session to £150 or more for a longer initial assessment, with home visits usually priced at the upper end of that range because they include travel. For our current published fees, please see the CK Physio bookings page, where prices are listed in full.
You do not need a GP referral to see a private physiotherapist. Self-referral is the norm in private practice. We do, however, work in close consultation with GPs and consultants where appropriate, and we recognise BUPA and AXA PPP for eligible patients.
Every physiotherapist at CK Physio is a Chartered Physiotherapist registered with the Health and Care Professions Council (HCPC). You can see our full list of professional memberships on our accreditations page, and you can read about our clinic and clinicians on the about us page. Feedback from patients we have supported over the years is on our testimonials page.
Rehabilitation usually begins in hospital within 24 to 48 hours of a stroke, once the person is medically stable. The 2023 National Clinical Guideline for Stroke recommends that a rehabilitation assessment be carried out within 24 hours of admission. For most people, physiotherapy then continues through the acute stroke unit, into any Early Supported Discharge programme, and beyond.
Outcomes after a stroke vary enormously and depend on the type and severity of the stroke, the person's overall health, and the intensity of rehabilitation they receive. Many people make meaningful improvements, some make very substantial recoveries, and progress can continue well beyond the first six months. No responsible physiotherapist can guarantee full recovery, but the message from current UK guidelines is unambiguous: rehabilitation potential should not be written off.
A stroke physiotherapist assesses movement, strength, balance, tone and function, then designs a personalised programme of task-specific practice, strength and balance work, gait retraining, and where appropriate, adjuncts such as electrical stimulation. They also educate families and carers, adapt exercises for the home environment, and liaise with the wider medical team.
There is no fixed number. Some people benefit from an intensive block of sessions over a few weeks to top up NHS therapy; others prefer regular weekly or fortnightly sessions over many months. Your physiotherapist will discuss a realistic plan with you at the initial assessment and review it as you progress.
Yes. Both the NHS and the Stroke Association make clear that meaningful improvement can continue for many months, and often years, after a stroke. Neuroplasticity does not have a fixed cut-off. Improvement later in recovery generally requires consistent, targeted practice rather than passive treatment.
No. Self-referral is standard in private physiotherapy in the UK. You can contact us directly, and we will arrange an initial assessment. Where useful, we are happy to liaise with your GP or consultant.
NHS stroke care in the UK is excellent in the acute phase, but national audit data has consistently shown that therapy intensity in the rehabilitation phase often falls short of the levels the 2023 guidelines now recommend. Private physiotherapy is designed to complement, not replace, NHS care — typically by adding sessions during rehabilitation or by continuing therapy after discharge.
Loose, comfortable clothing that allows movement of the arms and legs, and flat, supportive shoes if you have them. If a family member or carer usually supports you, we encourage them to attend the first session — their role in your recovery matters. Bring any relevant discharge summaries, medication lists or reports from previous therapy.
If you would like to talk to a Chartered Physiotherapist about your recovery, or arrange a home visit anywhere in the W5, W7 or W13 area, we would be glad to hear from you. There is no obligation, and we will always be straightforward about whether private physiotherapy is the right next step for you.
About the author
Bryan Kelly is a Chartered Physiotherapist and co-founder of CK Physio in Hanwell, West London. He is registered with the Health and Care Professions Council (HCPC) and a member of the Chartered Society of Physiotherapy. Bryan and the CK Physio team have been supporting patients across Hanwell, Ealing and the wider West London area since 2003.
This article was medically reviewed by Bryan Kelly in September 2026.
Disclaimer: This article is provided for general information only and is not a substitute for individual medical or physiotherapy assessment. If you have had a stroke or think you may be having one, call 999 immediately. For personalised advice on stroke rehabilitation, please speak to your GP, stroke consultant, or a HCPC-registered physiotherapist.