Intermediate Care

Enablement Service

The service is an integrated multi-disciplinary service, jointly funded and staffed by Lewisham and Greenwich NHS Trust and London Borough of Lewisham, which provides rehabilitation and support to adult Lewisham residents to return them to an optimum level of function after an admission to hospital.

We work with people who live in Lewisham, who are 18 or older – although the average age of people we see is 80 – who need some physical rehabilitation after being in hospital. We work with over 3,000 people per year.

Staff are based in multi-disciplinary teams who visit people in their own homes and in 25 Nursing Home beds, based in Brymore Nursing Home in Grove Park.

The service is available 7 days a week, 8am to 8pm. Currently referrals are only accepted on Monday to Friday between 9pm and 5pm.


Referrals are made by wards to the Discharge to Assess team (D2A team).

If the patient requires bed based rehabilitation the D2A team liaise with the ward and the bed based unit to ensure that the patients discharge to there is as smooth as possible.

If the plan is for the patient to return home the D2A team assist with the discharge arrangements and visit the patient soon after they have arrived home. Following an assessment to ensure that the patient is safe they then decide which pathway the patient should go onto: no further input, assessment for a permanent package of care, enablement care team (ECT) or supported discharge (including stroke early discharge.

Bed based Rehabilitation criteria

  • You are a Lewisham resident
  • 55 or over, although exceptions may be arranged
  • You are likely to improve significantly within 2 weeks (maximum stay amended in line with Covid-19 guidelines from the Department of Health)
  • Can transfer with maximum assistance of one (there are 5 beds where the patient can require double handed care)
  • Can follow and remember simple instructions
  • Willing to be treated by the Enablement staff including therapists
  • Requires rehabilitation input from one or more disciplines from the team

    Supported discharge team (including stroke pathway early discharge team) criteria:

  • You are a Lewisham resident
  • You are 18 or over
  • Can transfer independently or with the help of one carer and transfer equipment
  • Can follow and remember simple instructions
  • If you are living alone, you must be safe at home overnight and for periods during the day
  • Willing to be treated by the Enablement staff including therapists, and if a carer is involved, they are willing to have person treated by Enablement
  • Requires rehabilitation input from one or more disciplines from the team
  • The supported discharge team’s intervention is provided free for up to 6 weeks dependent on progress still being made but the average is approximately 4 weeks.

    The Multi-disciplinary team

    The multi-disciplinary teams are made up of nurses, social workers, physiotherapists, occupational therapist, therapy assistant practitioners and enablement officers, together with business support. In addition, there is support from the Care of the Elderly Consultant Team at UHL for patients undergoing bed based rehabilitation and support from a speech and language therapist for all teams as appropriate.

    Enablement nurses will help with medication reviews, monitor skin breakdown, help with incontinence issues, check pain management and work closely with the GP to support you becoming more independent.

    Physiotherapists will give you individual exercise programmes to help you move from one place to another, become stronger, less likely to fall, be more active and suggest and provide equipment, walking aides and other device to support your mobility.

    Occupational therapists will help you with activities that allow you to be more independent in washing, dressing, toileting, cooking, improve your memory, attention and problem solving, work leisure and education. They may advise on different methods of performing an activity or pieces of equipment to help you become more independent.

    Social workers will help you, your family and carers to deal with changes in your life, help you to organise paid carers to support you at home, make sure that you are safe and your needs are met appropriately and advise you about local resources.

    Our Enablement Officers will visit you daily and practice activities like washing and dressing, preparing a meal and help get you as independent as possible.

    Therapy Assistant Practitioners work closely with the therapists to monitor, review and progress your therapy.

    Where are we based?

  • Supported Discharge team is based in Honor Oak Health Centre
  • Bed based rehabilitation is provided at Brymore Nursing Home Grove park.

    Enablement provide every discharged patient with an anonymous customer satisfaction survey to complete, and these scores have been consistently at 80% or above in the “satisfied” or “very satisfied” range.