Neuro Rehabilitation OnLine (NROL)
Transforming Recovery, Together
NROL delivers cognitive, communication and physical therapy remotely via video to groups of patients, enabling more patients to be seen with the same clinician time.
The NROL programme was originally developed during the pandemic by SameYou in partnership with University College Hospital London, providing online therapy across Lancashire and South Cumbria.
In 2025, East Lancashire NHS Foundation Trust was awarded funding from SBRI Healthcare to support the expansion of the NROL model across Lancashire and South Cumbria and Cheshire and Merseyside using ELAROS’ autonom-e platform to scale group therapy provision; address the therapy gap for patients; and leverage specialist skills across a region.
- 1,250+ administrative estimated hours saved per annum compared to separate commissioned services
- 3.7X ROI per annum for Lancashire & South Cumbria's deployment with 7 delivery teams*
- 35% more patients expected to be seen in the first year following digital implementation
- Patients reporting improved physical recovery and better well-being
*When compared to separate commissioned services delivering therapy locally
BUILT WITH NHS TRUSTS, UNIVERSITIES, INDUSTRY & CHARITY PARTNERS
East Lancashire Hospitals NHS Foundation Trust
ELAROS
Health Innovation North West Coast
Lancaster University
SameYou
SBRI Healthcare
UCL Partners
Why does the NHS need NROL?
Many community and hospital outpatient rehabilitation services are often understaffed and overstretched by demand, where very few teams are able to deliver the recommended minimum 3 hours of multidisciplinary rehab per day at least 5 days a week.
The argument for NROL is not only about admin efficiency – it is about the clinical viability of delivering services locally without a purpose-built solution like autonom-e.
The problem
If each neuro-rehab delivery team in an ICB region has, at best, a part-time specialist neurological physiotherapist, an OT, and a SALT.
In community settings, those posts may be partially or wholly vacant — consistent with a 26% physiotherapy shortfall and a 21–23% SLT vacancy rate nationally.
Rarely does a single team have the full MDT breadth to deliver high-quality interdisciplinary group neuro-rehab.
The consequence without regionalisation
A standalone team with ~90 patients and a depleted MDT cannot run viable group therapy sessions. They deliver fragmented, reduced-intensity individual appointments — if anything at all.
The SSNAP audit shows fewer than 12% of patients receive even the old, weaker 45-minute standard. The new standard of 3 hours per day is being met by almost nobody in the NHS.
What the regional model makes possible
By pooling skills across multiple delivery teams, a single specialist neurological physiotherapist from one Trust can deliver group therapy to patients from all five teams in a single session.
A SALT who exists in only one team’s establishment can reach patients from three others. The regional model turns scarce specialist capacity into shared capacity — multiplying clinical reach without multiplying headcount costs.
autonom-e's role in this
Without autonom-e, this cross-team clinical sharing is impossible to manage safely — you can’t share patient records, coordinate MDT sessions across Trust boundaries, or maintain governance without the platform’s role-based access, single patient record, or a heck of a headache over email.
The platform isn’t just an admin tool; it’s the clinical infrastructure that makes shared specialist capacity legally and practically operable.
How does NROL work?
Instead of delivering rehab across multiple local services which rarely have sufficient specialist capacity or technology to meet complex patient need at scale, NROL is a regionally co-ordinated service which pools specialist skills and delivers tele rehab groups to maximise patient throughput and therapy intensity.
Lancashire’s NROL service demonstrated benefits before partnering with ELAROS, however co-ordinating group sessions and patient notes across NHS Trusts at scale proved challenging without our platform.
Autonom-e provides the purpose-built shared IT infrastructure across all therapy delivery teams which is co-ordinated by the “NROL Hub” in East Lancashire NHS Trust.
A regional licence model provides significant efficiencies with licence costs, staff time, and a single governance & procurement agreement across the ICB.
The case for delivering NROL across a region
For Patients
Access to multiple more intensity therapy sessions per week compared to 1:1 therapy
Manage appointments and reminders on mobile or tablet
Access session resources digitally at any time
Benefit from peer support with other patients
For Clinical Services
Digital triage and assessment using validated PROMs such as the PSFS, FSS, EQ-5D-5L.
Deliver validated tele rehab remotely to a group cohort
Patient-initiated follow-up (PIFU) for flexible discharge and safe re-entry.
Multidisciplinary coordination with occupational therapy, speech therapy, pain, and neuro-rehab teams.
For Commissioners
Significant cost efficiencies from a regional licence
Access to ICB-wide reporting from a single dashboard
Provide equity of access to patients, leveraging staff skills from across a region
For Governance Teams
1 regional data sharing agreement, DSPT, DTAC, Clinical Safety Case managed centrally
Centralised referral, discharge, and PIFU pathway
Secure data governance and role-based access control across all group sessions
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