Innovative stroke rehab model earns regional rollout

An innovative digital rehabilitation model, backed by Health Innovation North West Coast, has been commissioned across Lancashire and South Cumbria.

The Neuro Rehabilitation Online (NROL) model marks a major change in the way stroke and neurological rehabilitation services are delivered throughout the integrated care system (ICS). It also creates a blueprint for future delivery of other rehabilitation services.

NROL delivers real-time, clinician-led group rehabilitation sessions via video technology. The model has been designed to increase access to therapy, improve efficiency and support more equitable care for patients recovering from stroke and other neurological conditions. 

NROL was initially created by University College London and charity SameYou in 2020. It was brought to East Lancashire Hospitals NHS Trust and had some success, however a SBRI Health Care grant in January 2025 gave it the boost it needed to develop the service, and develop a framework to spread it throughout Lancashire and South Cumbria ICS and into neighbouring Cheshire and Merseyside.

Health Innovation North West Coast played a central role in supporting the programme’s success, providing strategic support and coordination to help partners align around a shared vision and build a compelling case for commissioning. This has been underpinned by a robust independent evaluation led by Lancaster University, demonstrating strong patient outcomes, high acceptability and sustainable system benefits.

SameYou’s continued involvement, and the close collaboration with Elaros, a digital innovator who provided the NROL platform, were also essential.  Elaros provided the digital platform for scheduling and patient access to rehabilitation materials and group sessions.

Steve Adams, Commercial Programme Manager of Innovation and Industry Partnerships for Health Innovation North West Coast, was closely involved throughout and said: “The strength of the NROL programme and team around it has enabled it to overcome one of the most persistent challenges in healthcare innovation: moving from short-term pilots to sustainable, system-wide adoption, and spread into other ICSs.”

The benefits of NROL are many. It enables clinicians to see patients more frequently by complementing in-person therapy, increase therapy intensity and reduce clinician travel time, helping services maximise existing workforce capacity without increasing demand on staff. By design, it meets several government priorities, including analogue to digital, hospital to community and net zero goals.

Evaluation highlights

Across Lancashire and South Cumbria and Cheshire and Merseyside (April 2024 – March 2026):

• More than 1,200 patients referred, with nearly 800 taking part
• NROL delivered more than 6,000 patient contacts through over 1,000 online rehabilitation sessions
• The programme has been adopted across 14 NHS trusts and 21 teams, demonstrating its potential to support rehabilitation delivery at regional scale
• Patients responded positively to the model, with 94 per cent of survey respondents rating their overall NROL experience as good or very good, while 89 per cent said NROL was an important part of their rehabilitation
• Dedicated technology support helped make the service accessible: 89 per cent of patients said they found joining online sessions easy
• By reducing travel, NROL avoided more than 100,000 driving miles, saving an estimated 3,700 driving hours and 33,000 kgCO₂e in carbon emissions
• Participation has been broadly representative of the population it serves, supporting equitable access across diverse geographical areas

In Lancashire and South Cumbria (expanded and commissioned phase, April 2025 to March 2026)

• Expansion of NROL increased the number of online rehabilitation sessions offered by 68 per cent, with patient contacts rising by 35 per cent
• The median amount of therapy received through NROL increased by a third during the expanded programme
• More than eight in 10 participants improved or maintained their activity performance during the programme (as part of hybrid care where patients also received in-person therapy during their programme)

“Neuro Rehabilitation Online has shown to have a clear impact for patients for both access and recovery outcomes and is in line with improving access to rehabilitation while demonstrating how embedding research, innovation and technology can improve outcomes for our population.

“The strong evidence, combined with clear patient benefit and operational efficiency, made it a compelling and sustainable investment for our system. This approach can be used as a blueprint for increasing the reach of other rehabilitation pathways, including frailty and long-term conditions.”

- Aaron Cummins, Chief executive, Lancashire and South Cumbria Integrated Care Board

“I wasn’t initially happy about joining a group, but once I did, I could 100% see the benefits. NROL helped me realise I wasn’t on my own, which made a huge difference and gave me motivation seeing others at different stages of recovery. The sessions were tough at first, but they really improved my strength, coordination and confidence. Having regular check-ins from clinicians was absolutely vital, otherwise I’d have just been sat at home without support. As a nurse, I can also see how effective this model is for the NHS. It’s made a real difference to my recovery, and I’d absolutely support it being rolled out more widely, with even more focus on family involvement and mental health support.”

- Kevin, NROL patient 

“NROL has been a vital part of my recovery. The opportunity to connect with others who truly understand what you’re going through is invaluable. It gave me confidence, motivation and a clearer sense of progress, and over time I’ve been able to return to work and now contribute back into sessions as a peer. I think there’s real potential to strengthen the offer further, especially with more tailored support for working-age patients, greater focus on confidence and mental health, and better involvement of carers. NROL has made a real difference to me, and I believe it could benefit many more people if it continues to evolve in this way.”

- Matt, NROL patient

Recognition

The impact of NROL has been recently recognised with two high-profile awards:

• Regional (north west) winner 2026 NHS Excellence Awards for Patient Involvement and Choice
• National award for the Best Collaboration across Clinical, Academia and Industry at the Advancing Healthcare Awards 2026

Case studies

• Commissioners
• Delivery teams

Full evaluation

• The full NROL evaluation will be made available on Lancaster University’s website in summer 2026.