Physiotherapy and occupational therapy

Therapy Specialty Lead for services at the Glenfield Hospital, Leicester General Hospital, and Leicester Royal Infirmary: Phillip Sykes ([email protected]) 

The Cardio-Respiratory therapy teams provide in-patient services at all three hospitals in Leicester and an outpatient service at Glenfield Hospital. 

Physiotherapy

Respiratory physiotherapy involves helping patients who are having difficulty with their breathing. Their treatment may include advice and education on different breathing techniques, and instruction and assistance with coughing and clearing secretions from their chest. Patients might need respiratory physiotherapy after an operation i.e. heart surgery, major abdominal surgery, or due to a medical condition such as COPD (Chronic Obstructive Pulmonary Disease), asthma and cystic fibrosis. Physiotherapists also work in intensive care. Respiratory treatments take place at the patient’s bedside or within outpatients clinics. 

Physiotherapy services can be used at all ages and at all stages of disease, from early diagnosis, through chronic illness, to acute episodes and care at the terminal stage. The physiotherapist’s role in patient care includes assessment, advice, education and hands-on intervention. They aim to: 

• Maintain or improve exercise tolerance 
• Improve functional abilities (i.e. carrying out daily tasks, transfers, walking and stairs) 
• Maintain and improve physical activity, coaching patients toward improving healthy behaviour 
• Reduce breathlessness and the work of breathing 
• Improve the efficiency of ventilation 
• Support weaning from mechanical ventilation and set up non-invasive mechanical ventilation 
• Improve knowledge and understanding 
• Reduce pain 
• Discharge support for safe transition from hospital to home 

Occupational therapy

Occupational therapy “enables people to achieve health, well-being and life satisfaction through participation in occupation” (College of Occupational Therapists, 2004). 

Occupational therapists aim to identify the patient’s problems and goals, and to find a solution to them. We assess the patient, identify problems, set goals, review treatment and plan for discharge. Our aim is to help patients to function as fully as possible in their chosen activities. 

All assessments and activities provided by the Occupational Therapy Department are planned and customised to meet the needs and preferences of the patient.   

Occupational therapy offers a variety of services: 

• Standardised and locally adapted functional assessments of personal and domestic daily living activities 
• Cognitive, perceptual assessments and treatments 
• Self-management techniques including teaching strategies to maintain optimum function including energy conservation, anxiety management and relaxation 
• Intervention that encourage social skills, address cognitive deficits and promote physical and mental health well being 
• Home assessments and provision of adaptive equipment 
• Advice and education regarding long term condition management 

Occupational therapy and physiotherapy inpatient services: 

Glenfield Hospital 

• Cardiac adult surgery 
• Adult intensive care unit & extracorporeal membrane oxygenation (ECMO) 
• Cardiology and coronary care unit 
• Clinical decisions unit 
• Thoracic surgery 
• Respiratory medicine, including cystic fibrosis and bronchiectasis 
• Respiratory support unit 
• Vascular surgery 
• Renal and hepato-pancreato-biliary surgery 

Find accessibility information on the AccessAble website.

Leicester Royal Infirmary

• General intensive care unit including trauma and A&E 
• Respiratory medicine 
• General surgery including maxillo-facial unit 

Leicester General Hospital

• High dependency unit 
• Urology 

Physiotherapy outpatient services and clinics at the Glenfield Hospital

• Dysfunctional breathing
• Bronchiectasis
• Cystic fibrosis and other chronic pulmonary disorders 

Physiotherapy and Occupational Therapy (OT) service for patients across Medicine and A&E speciality focusses on preventing complications, restoring function and improving independence utilising a range of interventions. 

Our inpatient therapy teams provide therapy services to wards at the Leicester Royal Infirmary and Leicester General, including to: 

• Medicine 
• Acute stroke 
• Acute neuro 
• Acute medical admissions units 
• Adult emergency department 

The therapy team also cover specialist units including the Brain Injury Unit (BIU), Specialist Neuro Rehabilitation Unit (SNRU) and Stroke Rehabilitation Ward at the Leicester General. The therapy services work as part of a multidisciplinary team collaborating with other healthcare professionals to provide holistic care, tailored to patient’s specific needs.   

You can find accessibility information for physiotherapy department at Leicester General Hospital. 

If you are a health professional you can refer into our services via email to [email protected]

Musculoskeletal services 

Our musculoskeletal service provides inpatient and outpatient physiotherapy at all three hospital sites, as well as local GP surgeries. 

The physiotherapy departments are situated in the locations below: 

• Leicester Royal Infirmary, Physiotherapy outpatient department, Balmoral building, level 0, can be easily accessed by the Havelock street entrance 
• Glenfield Hospital, Physiotherapy outpatient department, ground floor 
• Leicester General, Physiotherapy outpatient department, ground floor, near the Gwendolen Road entrance 

Inpatient services

Inpatient physiotherapists pick up all-new admissions to the wards they cover, allowing early treatment as appropriate.  

You will see us on: 

• Inpatient elective orthopaedic services at the Leicester General Hospital. 
• Burns & plastics service is at Leicester Royal Infirmary. 
• Trauma orthopaedic services cover 4 wards at the Leicester Royal Infirmary.   
• Women’s health services at the Leicester General and Royal Infirmary. 

Outpatient services 

Our outpatient service is aimed at providing high-quality evidence-based care for all patients who have a musculoskeletal (bone, muscle or joint) problem. 

Outpatient physiotherapy is aimed at providing you with the tools to effectively recover and return to normal life as quickly possible, allowing you to develop management strategies to assist with your condition. 

Outpatient physiotherapists work in several specialist areas including: 

• Hands, burns and plastics 
• A&E (Emergency Department)
• Fracture clinic 
• Pain management 
• Rheumatology 
• Sport medicine 

Outpatient services are available across all three sites; Glenfield, Leicester General and Leicester Royal Infirmary. 

Referral 

What do I do if I think I need Physiotherapy? Currently, you can be referred by your consultant, doctor (GP) or ward-based therapist. Alternatively, you can find the self-refer to physiotherapy form below. 

Self-referral 

If you self-refer to physiotherapy you will be contacted via telephone by a senior member of our team who will discuss your referral with you. This will be from a private or unknown number. Please note, we are unable to speak to family members over the phone. If you are unable to speak to us directly over the phone, please tick the box asking not to receive a phone call and you will be sent an appointment letter. 

If you are under a consultant for the problem, you are considering referring yourself for, unfortunately, we are unable to see you about this until receiving a referral from your consultant. 

Following the telephone conversation, we may provide you with advice regarding your problem and if appropriate book you into a 1:1 appointment with one of our therapists. 

Physiotherapy self-referral form (94kB pdf)

Our team 

We are currently involved in a variety of research trials working with orthopaedic consultants and furthering our profession. 

Alongside this, your physiotherapist will provide you with advice and education surrounding return to your normal activities and work. We are skilled in a range of techniques that can be used if appropriate to help in your recovery. 

Outpatient physiotherapy can include: 

• Exercise classes 
• Progressive individualised exercises 
• Useful advice and education to help you manage your condition. 

Outpatients appointments

Below is a list of frequently asked questions (FAQs) by patients who have an outpatient physiotherapy appointment: 

What happens at the first appointment?

Please report to the reception desk on arrival in the Physiotherapy Department. You must do this on every visit to the department to comply with fire regulations. Your first appointment will normally be 45 minutes and follow up appointments are usually 15 to 30 minutes.  

Your physiotherapist will ask you questions about your injury/problem and how you are feeling generally. Then they will usually examine the affected area. Your physiotherapist will create a treatment plan and there will be time for you to ask any questions. 

Once referred for physiotherapy, you will meet someone from our team who will ask you about your story so far and what you would like to achieve from treatment. Following this, they will see how you move, look at your strength and what you are able to do. Your initial appointment will include a thorough examination. 

Our physiotherapists can provide you with an individualised treatment programme and coach you through this journey. 

What if I arrive late for my appointment? 

If you are late for your appointment, we cannot guarantee that you will be seen, so please give yourself plenty of time. 

3. What if I can’t come to the appointment? 

If you are unable to come to your appointment please contact the department as soon as possible so we can try to use the appointment for another patient.  Let us know at least two days before your appointment if you will not be able to come. 

If you missed an appointment and didn’t let us know but still think that you need physiotherapy, ask your GP or consultant to refer you again. 

If you fail to attend your appointment and do not let us know in advance, you may not be given another appointment and may be discharged. 

4. What should I bring with me? 

• Any medication that you may need while you are here. 
• A list of all the medication you are currently taking. 
• Details of any other clinic appointments that you may have. 

5. What should I wear? 

Your physiotherapist may need you to undress to be able to fully assess the affected area or problem. Your privacy will be respected at all times. For your first assessment we suggest you wear: 

• Loose comfortable clothing 
• Underwear 
• You may wish to bring a pair of shorts or vest with you to change in to

6. What if I have any special needs? 

When you call to make your appointment, please tell the receptionist if: 

• You have a medical condition, which means that you would be unable to arrange your own transport or use public transport 
• You would like to have a physiotherapist of the same sex  
• You would like to bring a same-sex friend (chaperone) to keep you company during your appointment 
• If you need an interpreter, please contact the Physiotherapy Department as soon as possible before your appointment so that we can try to help you. 

9. What should I expect from my treatment? 

Everyone’s treatment is individualised depending on what is most appropriate for them and their goals. A significant part of physiotherapy involves exercises, movement modification and modification of your valued activities. We believe that education around your condition and how to manage it is essential for a good outcome as well as providing you with strategies to self-manage in the future. Alongside these principles, other treatments can be used to help with your recovery. 

Therapy Speciality Lead for Elective and Trauma Orthopaedics and Hand Therapy – Caroline Timms  

Therapy Speciality Lead for Therapy Out-patients (MSK, Pelvic Health, Respiratory) and Paediatrics – Sarah Sykes  

Occupational Therapy and Physiotherapy services within the Oncology and Haematology areas at the Leicester Royal Infirmary, provide assessment and treatment to inpatients with having cancer treatment or have a diagnosis of cancer. This service covers ward 39, ward 40, ward 41, bone marrow transplant unit and Teenage and young adults WARD (27A) and Oncology and Haematology assessment unit at the Leicester Royal Infirmary.

The paediatric physiotherapy service provides both inpatient and outpatient services at Leicester Royal Infirmary for children from birth up to 16 years (dependent on the complexity of the child’s needs).  

Physiotherapy

• Inpatient services: The paediatric physiotherapy team assess and treat children with respiratory conditions including cystic fibrosis, primary ciliary dyskinesia, difficult asthma and bronchiectasis. We also treat children with neurological and musculoskeletal conditions in addition to treating children with cardiac conditions as part of the East Midlands Congenital Heart Centre. We provide physiotherapy cover for all of the children’s wards in addition to outpatient clinics, the emergency department and the neonatal unit. Physiotherapists assess and treat children with respiratory, neurological and musculoskeletal conditions on the wards, in clinics and also within our therapy gym. Some of our physiotherapists provide respiratory care at the child’s home depending on the child’s needs. 
• Outpatient services: Our outpatient service is based at Leicester Royal Infirmary. Children are referred from consultants and General Practitioners (GPs) with a variety of conditions including musculoskeletal, pain management and respiratory conditions. Following assessment children may be treated on an individual basis or within a group setting. We have a children’s gym at the Leicester Royal Infirmary. Physiotherapists also provide assessment and treatment within outpatient clinics working alongside our Paediatric Orthopaedic Consultants. 

Occupational therapy

• Inpatient services: The paediatric Occupational Therapy team works on all of the children’s wards within the Children’s Hospital including East Midlands Congenital Heart Service and the Neonatal units. Occupational Therapists assess and treat children with long term ventilation needs, neurological, musculoskeletal, and orthopaedic needs both following surgery and after trauma. We provide intervention focusing on developmental skills, rehabilitation, participation in activities of daily living, and possible equipment provision for home.  Access visits to patient’s homes are sometimes completed to assess for equipment to enable discharge home. 
• Outpatient services: We have a small outpatient service based at Leicester Royal Infirmary. Children with Juvenile Idiopathic Arthritis are referred from the specialist consultant and receive intervention focusing on participation in activities of daily living, participation at home and school and upper limb splinting if required. We work closely together with our Physiotherapy colleagues both on the wards and in outpatients. 

Therapy Speciality Lead: Sarah Sykes 
Email: [email protected] 

Our pelvic health service provides inpatient and outpatient physiotherapy services at Leicester General Hospital. 

• Inpatient services: Inpatient Physiotherapists or Physiotherapy assistants see patients on maternity wards who have been referred by their midwife or doctor. This may be because of a more difficult delivery or they are experiencing bladder or bowel problems. Useful information and exercises after having a baby can be found here. 
• Perineal clinic: Specialist Physiotherapists see patients in the perineal clinic at around 6 weeks postnatal who may need more guidance after the birth of their baby, for example following a 3^rd or 4^th degree tear. There is further guidance on this clinic and what to expect here: www.leicestermaternity.nhs.uk/postnatal/perineal-clinic-information 
• Outpatient services: Our outpatient service is aimed at providing high-quality evidence-based care for all patients who have a pelvic health problem. This may include pregnancy or postnatal care, bladder, bowel, prolapse or sexual problems, or more long term issues with pelvic pain. 

Here is some information on some of the common conditions that are treated with pelvic health physiotherapy: 

• Pregnancy-related pelvic girdle pain 
• Tummy muscle separation 
• Bladder, bowel, prolapse, sexual or chronic pelvic pain problems 

Pregnancy-related pelvic girdle pain 

Approximately 1 out of 5 people will experience pelvic pain during pregnancy. There are many ways in which you can manage this. 

There is lots of useful information on how to manage pregnancy-related pelvic pain in these booklets, can be searched in our patient information leaflets. Watch these short videos for tips on how to move differently to help reduce pain: Pregnancy fitness and exercise tips – YouTube. 

Ask your midwife to refer you if you need further support. 

Physiotherapy may include: 

• Useful advice and education to help you manage your condition- this may be in a one-to-one or group format. 
• Individualised exercises 
• Mobility aids 

Tummy muscle separation 

This usually relates to pregnancy or after having a baby. The band that joins the tummy muscles becomes thinner and wider in all pregnancies so the muscles become further apart. This is called diastasis rectus abdominus (DRA). Further information on this can be found via our patient information lealfets. 

Pelvic health physio may include: 

• Useful advice and education eg ways to reduce pressure in the tummy during activities, advice to reduce constipation or straining. 

• Individualised exercises to improve tummy muscle function 

Bladder, bowel, prolapse, sexual or chronic pelvic pain problems 

Pelvic health physio may include: 

• Useful advice and education on management eg lifestyle advice, bladder retraining, constipation advice 
• Pelvic floor muscle assessment- this usually involves an internal assessment via the vagina or anus to see how your muscles are working. This will be discussed with you first, if appropriate, and you will have the option of a chaperone. 
• EMG Biofeedback- this uses equipment to help teach you how to work or relax your pelvic floor muscles more effectively by giving you visual cues. 
• Pelvic floor electrical stimulation- using equipment to help you with your pelvic floor exercises. 
• Pelvic floor rehabilitation- individualised exercises and global rehabilitation programme to improve pelvic floor muscle function. 
• Pelvic floor relaxation – sometimes the muscles need relaxing rather than (or as well as) strengthening- this may include stretches, breathing exercises, massage 
• Pain management- to help you understand and manage pain 

Useful resources 

Bladder and Vaginal Prolapse problems: 

• Education group: https://youtu.be/DAyvCB57tRI and https://youtu.be/Mgfe5m1jeUQ 
• Bladder health: https://youtu.be/37X8TmcrtJQ 
• Prolapse video: https://youtu.be/PQ5ZkNQhkv8 
• Bowel health: https://youtu.be/7gTgLfCG_3c 
• Pelvic floor exercises: https://youtu.be/ZHUC46WjRAw 
• Exercises to strengthen the pelvic floor muscles for women

Advice following gynaecological surgery: pogpffsurgery.pdf (thepogp.co.uk) 

The Pelvic Obstetric Gynaecological Physiotherapy webpage also has useful resources on: 

• Prolapse: 20xxx-POGP-ProlapseUpdated (thepogp.co.uk) 
• Pelvic floor exercises for women: Pelvic Floor (thepogp.co.uk) 
• Pelvic floor exercises for men: Pelvic Floor Men.pdf (thepogp.co.uk) 
• Bowel problems: Bowel Function.pdf (thepogp.co.uk) 

For further advice on bowel problems: Pelvic Floor Service (leicestershospitals.nhs.uk) 

For help managing and coping with bladder and bowel problems: Supporting Your Bladder & Bowel Health | Bladder & Bowel Community (bladderandbowel.org) 

Pelvic floor relaxation tips: Start relieving your pelvic pain – release your abdominals! – YouTube 

Also consider general relaxation tips, such as: 

• Meditation and mindfulness: www.headspace.com 
• Mitchell method of relaxation: POGP-Mitchell.indd (thepogp.co.uk) 
• Chronic pain management- Understanding chronic pain: Tame the Beast 

Pelvic health outpatients FAQs 

Below is a list of frequently asked questions (FAQs) by patients who have an outpatient pelvic health physiotherapy appointment: 

1. What happens at the first appointment? 

Please report to the reception desk on arrival in the Physiotherapy Department. You must do this on every visit to the department to comply with fire regulations. Your first appointment will normally be 45 minutes and follow up appointments are usually 30 minutes We aim to be prompt, so if you are still waiting 10 minutes after your appointment time, please report this to the reception. 

Your physiotherapist will ask you questions about your problems and how you are feeling generally. Please have a list of any prescribed medicines that you take to hand. You may be examined on the first session depending on what is appropriate, your wishes and time available. 

Your physiotherapist will work out a treatment plan with you and there will be time for you to ask any questions. 

2. What if I arrive late for my appointment? 

If you are late for your appointment we cannot guarantee that you will be seen, so please give yourself plenty of time. 

3. What if I can’t come to the appointment? 

If you are unable to come to your appointment please contact the department as soon as possible on 0116 2584070so we can try to use the appointment for another patient. 

Please try to let us know at least two days before your appointment if you will not be able to come. 

If you missed an appointment, and didn’t let us know but still think that you need physiotherapy, ask your GP or consultant to refer you again. 

If you fail to attend your appointment and do not let us know in advance you may not be given another appointment and may be discharged. 

4. What should I bring with me? 

• Any medication that you may need while you are here. 
• A list of all the medication you are currently taking. 
• Details of any other clinic appointments that you may have. 

5. What should I wear? 

For your first assessment we suggest you wear: 

• Loose comfortable clothing 
• Avoid “all-in-one” outfits if you think you may need an internal examination 
• You may wish to bring a pair of shorts or vest with you to change in to 

Your privacy will be respected at all times. 

6. What if I have any special needs? 

When you call to make your appointment, please tell the receptionist if: 

• You have a medical condition, which means that you would be unable to arrange your own transport or use public transport 
• You would like a chaperone present for an internal examination 
• You would like to bring a friend or relative to support you during your appointment 

If you need an interpreter, please contact the Physiotherapy Department as soon as possible before your appointment so that we can try to help you. 

7. How do I find it? 

Pelvic health physiotherapy is in the Physiotherapy Department at Leicester General Hospital. Park in car park 1 and enter the hospital via the main entrance, turning right and following a long corridor down to the end. This will be signposted as “Rehabilitation”. Please note this is in a different location to maternity services.

Therapy Speciality Lead for Pelvic Health Physiotherapy Services: Sarah Sykes: [email protected]