Who We Are
The Robert Fergusson Unit (RFU) is located at the Royal Edinburgh Hospital in the Morningside area of Edinburgh. We were originally housed in MacKinnon House within the Royal Edinburgh Hospital. In 2017 we moved to a purpose built unit which has 20 en-suite bedrooms, therapy/interview rooms, family room, physiotherapy gym, activities of living kitchen, group room, games room, social areas and enclosed courtyards.
The RFU is a national NHS neurorehabilitation service for patients with acquired brain injury and associated behavioural disturbance. We aspire for our service to be available to the broadest range of patients who would benefit from the specialist skills of a neurobehavioural multidisciplinary team.
There is also access to gardening, music and social activities within the Royal Edinburgh Hospital campus; there are opportunities for our patients to work with the hospital volunteer service.
The unit has its own lease car and access to further pool cars.
The hospital is in close proximity to a wide range of shops, cafes and restaurants and there are good transport links to the city centre through local buses.
Referrals
Referrals to the service can be through a consultant physician, consultant surgeon, consultant psychiatrist or a general practitioner.
Patients will be assessed on a case by case basis. Those who would potentially benefit from our service would generally:
- Have an acquired brain injury
- Exhibit challenging behaviour (e.g. severe agitation/aggression), which is preventing effective engagement with local services
- Require specialist neuropsychiatric assessment and treatment (e.g. because of co-morbid psychiatric illness)
- Be able to be safely treated in the RFU, which is a locked ward but not a secure unit
- Be 18 to 65 years old (referrals out with these ages are considered on a case by case basis)
All patients referred to the RFU will have a joint assessment carried out by a member of the medical and nursing team. A decision will be made relatively quickly regarding whether the patient would benefit from a period of assessment and rehabilitation in the RFU. If deemed suitable for admission the patient may have to be placed on a waiting list. In some cases it may be decided that admission to the RFU is not necessary or appropriate; in these cases clinical advice on management will be provided to the referrer if deemed helpful.
Length of Admission
Though patients needs will be assessed on a case by case basis, generally a minimum of three months is required to enable a comprehensive assessment to be carried out and time to evaluate the outcome of individualised treatment approaches; including a review of medication and behavioural modification approaches. A case conference is held three months following admission to review progress and all relevant parties are invited to attend.
Treatment Provided
The RFU aspires to a culture of optimism, respect and unconditional positive regard. We provide highly personalised treatment with an emphasis on relationship building and social engagement, Through a dynamic programme of therapeutic intervention, positive risk taking and reward focussed behavioural approaches we try to optimise rehabilitation/habilitation and support patients to meet their needs in an adaptive and sustainable manner.
We support patients with adjustment to life after brain injury. Our overriding priority is to improve their quality of life. We aim to maximise the engagement of family and friends in the rehabilitation process, while acknowledging their own struggles with adjustments to loss.
The RFU provides multidisciplinary assessment and treatment by a highly specialist team who are skilled in neurobehavioural assessment and treatment.
Specific interventions provided in the RFU include:
- Neuropsychiatric assessment
- Behavioural monitoring and formulation
- Development and delivery of goal-focused behavioural interventions
- Brain injury education and support/facilitation of adjustment
- Individual cognitive behavioural therapy
- Pharmacological treatment
- Carer and family support, education and training
- Skilled nursing care
- Physiotherapy
- Speech and Language Therapy
- Occupational Therapy
- Art Therapy
- Specialist addictions assessment and treatment
- Prominent focus on social engagement and community based activities
Outcomes
Through the above interventions the RFU aims to:
- Optimise care approaches to minimise behavioural disturbance
- Provide the structure and approaches to support optimal functioning within the patient’s cognitive, communicative, physical and social abilities
- Define and establish effective symptom management (e.g. for pain, fatigue sleep disturbance)
- Treat psychiatric co-morbidity
- Encourage the patient’s participation in meaningful activities, support them therapeutically and maximise their quality of life
- Support a seamless transition from the RFU to subsequent care (residential resource/ supported accommodation/ own tenancy with support) with the support of the RFU Outreach Service.
