Professional Guide to Botulinum Toxin Services

Specialist Spasticity Management Services

Next Steps Spasticity Clinic provides specialist botulinum toxin administration for the management of spasticity and dystonia.

Our service is delivered by HCPC-registered physiotherapists with advanced training in spasticity management.

Client Pathway - Assessment and Treatment Process

Initial Referral and Assessment

  1. Comprehensive evaluation in client's home environment

  2. Detailed spasticity and functional assessment

  3. Discussion of goals and expectations

  4. Development of personalised treatment plan

  5. Coordination with legal teams and case managers

Treatment Implementation

  • Botulinum toxin injection sessions as clinically indicated

  • Implementation of positioning and postural management strategies

  • Custom splinting and casting when appropriate

  • Training for family members and caregivers

  • Integration with broader rehabilitation plan

Ongoing Management

  • Regular review appointments to monitor progress

  • Objective measurement of outcomes

  • Adjustment of treatment plans as needed

  • Comprehensive reporting for both clinical and legal purposes

  • Coordination with other healthcare providers

Clinical Indications

Upper and lower limb spasticity secondary to:

  • Stroke

  • Traumatic brain injury

  • Multiple sclerosis

  • Spinal cord injury

  • Cerebral palsy

Focal dystonia

Post-stroke spasticity

Neurological movement disorders

Clinical Governance

Quality Assurance

  • HEPC & CSP standards adhere to all individual kit prescribed per patient

  • Robust, smart goals, in place

  • Comprehensive regular, update, training completed by all therapists

  • Specialist qualified ?????

  • Regular clinical audits

  • Outcome measure tracking

  • Patient satisfaction monitoring

  • Adverse event reporting

Documentation Standards

Comprehensive assessment documentation

  • Informed consent

  • Treatment records including:

    • Muscle selection

    • Doses administered

    • Batch numbers

    • EMG/US findings where applicable

    • Post-treatment care plan

Medico-Legal Information

Consent Process

  • Detailed discussion of risks/benefits

  • Documentation of capacity assessment where relevant

  • Written informed consent obtained

  • Information provided in accessible format

Risk Management

Standardised assessment protocols

  • Emergency management procedures

  • Regular staff training

  • Clear clinical governance structure

Service Specifications

Referral Criteria

  • Confirmed neurological diagnosis

  • Failed conservative management

  • Clear functional goals

  • No contraindications

Referral Process

Direct referral from:

  • Consultants

  • Solicitors

  • GPs

  • Allied Health Professionals

  • Self-referral with appropriate clinical information care plan

Clinical Pathways

  1. Initial Assessment

Comprehensive spasticity assessment

Goal setting

Treatment planning

2. Treatment Phase

Ultrasound guided injections

Post-injection assessment & monitoring

Therapy programme initiation

3. Follow-up

Review at 2-4 weeks

Outcome measures assessments

Post treatment follow up report provided

Treatment modification if required

Re-injection at 12 weeks or as required

Insurance and Funding

  • Accepted insurance providers

  • Pre-authorisation requirements

  • Self-funding options

  • Payment terms

For information about costs & funding:

Our Coverage Areas

Serving patients across the North of England, including:

CHESHIRE

LIVERPOOL

SHROPSHIRE

STAFFORDSHIRE

MANCHESTER

LANCASHIRE

NORTH WALES

YORKSHIRE

MIDLANDS