Concierge neuro-rehabilitation · UK
Prolonged disorders of consciousness - an accurate diagnosis, handled with care.
Specialist assessment and rehabilitation after severe brain injury, for the vegetative and minimally conscious states. A consultant-led multidisciplinary team, validated assessments repeated over weeks, and honest support for families through diagnosis, prognosis and best-interests decisions.
Why families choose us
- 01
A consultant in rehabilitation medicine, leading
A named specialist in disorders of consciousness with the multidisciplinary team the RCP guidelines require - not a general ward and not a single visiting doctor.
- 02
Structured, validated assessment
Diagnosis rests on repeated, standardised assessments over weeks - CRS-R, WHIM and SMART - because a single bedside look misses signs of awareness. We use the recognised tools, properly.
- 03
Independent, and free
We are paid by no unit, so the advice - including whether a second opinion or a move to specialist rehabilitation is warranted - is impartial and costs your family nothing.
Indicative pricing
What private assessment and rehabilitation costs in the UK.
Indicative ranges across our partner neuro-rehabilitation services. Send the details and we quote firm figures, and explain how funding usually works, with cover checked.
In short
A structured inpatient assessment: £18,000–£45,000 over four to six weeks.
| Service | Indicative range | Typical duration | Setting |
|---|---|---|---|
| Rehabilitation medicine consultation | £300–£600 | 45–60 min | Same visit |
| Second-opinion diagnostic review | £1,500–£3,500 | Records + visit | 1–2 weeks |
| Serial CRS-R / WHIM assessment block | £2,500–£6,000 | Multiple sessions | 2–4 weeks |
| Structured inpatient assessment (4–6 weeks) | £18,000–£45,000 | 4–6 weeks | Inpatient |
| Specialist neuro-rehabilitation, per week | £3,500–£8,000 | Per week | Inpatient |
| Best-interests / capacity report | £2,000–£5,000 | Assessment + report | 2–3 weeks |
| Case management set-up | £1,500–£3,000 | Assessment + plan | 1–2 weeks |
Costs vary by unit, by the length and intensity of assessment, and by whether ongoing rehabilitation follows. Many families fund this through NHS continuing healthcare, health insurance, or a personal-injury settlement coordinated by a case manager. We come back with firm figures and funding guidance within one working day.
The problem
An accurate diagnosis, a realistic prognosis, and families kept informed.
This is where general services can fall short - a rushed diagnosis, reversible factors missed, and families left without a clear picture. We address all three with a structured, guideline-based approach.
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Assess properly, over time
Signs of awareness are subtle and inconsistent. Repeated, validated assessment over weeks is the only reliable way to get the diagnosis right.
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Rule out the reversible
Sedation, seizures, infection and poor positioning can all mask awareness. These are checked and treated before any diagnosis is settled.
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Support the decisions that follow
An accurate diagnosis underpins best-interests decisions, including nutrition and hydration, made carefully under UK law.
The journey
From enquiry to a clear picture - what happens, in order.
One team from your family’s first message through assessment, diagnosis and an ongoing care plan.
Phase 1 · Before assessment
Records, imaging, medical review
Phase 2 · During assessment
Structured multidisciplinary evaluation
Phase 3 · After
Diagnosis, care plan, review
- 01
Before
Your family tells us what has happened
A confidential conversation. The nature of the brain injury, how long ago, the current diagnosis, where the person is cared for now, and what the family most wants to understand.
- 02
Before
We come back with a recommendation
Within one working day: whether a structured assessment or second opinion is likely to help, which specialist team fits, an indicative cost, and how funding usually works.
- 03
Before
Records, imaging and medical review
We gather the acute records, brain imaging and current medication so the specialist starts with the full picture, and screen for reversible factors such as sedation, infection or seizures that can mask awareness.
- 04
During
Admission for structured assessment
Admission to a specialist unit for a programme of repeated, standardised assessments over several weeks, optimising positioning, medication, communication aids and the environment to give the best chance of a response.
- 05
During
Multidisciplinary evaluation
Rehabilitation medicine, neuropsychology, physiotherapy, occupational therapy and speech and language therapy each contribute, building an accurate picture of vegetative, minimally conscious or emerging states.
- 06
After
Diagnosis, prognosis and family meeting
A clear written diagnosis and prognosis, explained in a family meeting - what the findings mean, what is uncertain, and the realistic outlook, at a pace the family can absorb.
- 07
After
Care plan, best interests and review
A rehabilitation and care plan, support for best-interests decisions including clinically assisted nutrition and hydration, and scheduled reassessment, because the picture can change over months.
Typical structured assessment: four to six weeks. Reassessment: planned over months, as the picture can change.
When it helps
When a specialist service is the right step.
The situations we see most, plus the one red flag that means urgent reassessment rather than a routine wait.
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Severe traumatic brain injury
A prolonged disorder of consciousness following major head injury, where specialist assessment clarifies the diagnosis and outlook.
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Hypoxic-ischaemic brain injury
Reduced consciousness after cardiac arrest or a period without oxygen, which needs careful, repeated evaluation over time.
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Stroke or brain haemorrhage
A severe bleed or large stroke leaving the person unresponsive or minimally responsive, requiring structured assessment.
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Vegetative state (unresponsive wakefulness)
Wakefulness without evidence of awareness - a diagnosis that must be confirmed carefully, as signs can be subtle.
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Minimally conscious state
Fluctuating but definite signs of awareness. Distinguishing this from vegetative state changes prognosis and care, and needs repeated testing.
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Uncertainty needing a second opinion
Where families or clinicians are unsure of the diagnosis, an independent structured review can confirm or revise it.
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Best-interests and treatment decisions
Support for difficult decisions, including clinically assisted nutrition and hydration, grounded in an accurate diagnosis and UK law.
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Red flag: new signs of awareness or decline
Emerging responses, or a sudden deterioration, warrant urgent reassessment - the diagnosis is never fixed and must be revisited.
What we assess
The tools and the team behind an accurate diagnosis.
What the programme involves - validated assessments, careful screening for reversible factors, and a multidisciplinary team working to national guidelines.
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Coma Recovery Scale-Revised (CRS-R)
A validated, structured assessment repeated over time to detect and grade signs of awareness that a bedside examination can miss.
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Wessex Head Injury Matrix (WHIM)
A sensitive tool that tracks the sequence of behaviours as a person emerges from a disorder of consciousness.
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SMART assessment
The Sensory Modality Assessment and Rehabilitation Technique - a formal programme testing responses across the senses over several weeks.
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Reversible-factor screening
Reviewing sedation, seizures, infection, hydration and posture, because treatable factors can suppress responses and mimic a deeper disorder.
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Neuroimaging review
Careful review of CT and MRI, and occasionally functional imaging, to correlate structure with the clinical picture.
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Multidisciplinary rehabilitation
Physiotherapy, occupational therapy, speech and language therapy and neuropsychology working together to prevent complications and support any recovery.
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Best-interests and legal support
Guidance on decision-making under the Mental Capacity Act, including when the Court of Protection is involved in treatment decisions.
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Long-term reassessment
Planned review over months, because a proportion of people move from vegetative to minimally conscious states or beyond.
Our vetted UK network
A small panel of neuro-rehabilitation specialists, we picked them.
Consultants in rehabilitation medicine and their multidisciplinary teams across the UK. Introductions are made privately, once we understand your family’s situation.
Selection criteria
How we choose every service in our network.
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Consultants in rehabilitation medicine with specific expertise in disorders of consciousness
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A full multidisciplinary team as required by the RCP national clinical guidelines
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Use of validated, repeated assessments - CRS-R, WHIM and SMART - rather than single bedside judgements
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Clear support for families through diagnosis, prognosis and best-interests decisions
Safeguards and support
What to expect from the process - honestly.
Getting this right matters enormously. The things worth understanding are why assessment takes time, how misdiagnosis is avoided, and how decisions and families are supported.
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Diagnosis takes time and repetition
A prolonged disorder of consciousness cannot be diagnosed in a single visit. Repeated, structured assessment over weeks is essential and is what the guidelines require.
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Misdiagnosis is a real risk
Studies show a meaningful rate of misdiagnosis when informal assessment is used. Standardised tools and an experienced team reduce that risk substantially.
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Reversible factors are checked first
Sedative medication, seizures, infection, pain and poor positioning can all suppress responses. These are identified and treated before any diagnosis is settled.
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Preventing complications matters
Skilled nursing and therapy reduce pressure sores, contractures, chest infections and spasticity - problems that harm comfort and any prospect of recovery.
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Prognosis is given honestly
The specialist explains what the findings mean and what remains uncertain. Timeframes matter - outlook differs between traumatic and non-traumatic injury.
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Decisions follow UK law
Treatment decisions, including clinically assisted nutrition and hydration, are made in the person’s best interests under the Mental Capacity Act, sometimes with the Court of Protection.
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The family is supported throughout
Clear communication, time to ask questions, and psychological support are part of the service, not an afterthought.
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The picture can change
Some people transition to a minimally conscious state or emerge further over months. Planned reassessment ensures a diagnosis is never treated as permanent without review.
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When to seek urgent review
New responsiveness, seizures, breathing difficulty, fever or a sudden change in condition should prompt the specialist team promptly rather than a routine wait.
Reading the assessment report
The report in four parts. Read the last one first.
Whichever service carries out the assessment, the report your family receives keeps to the same shape.
A quiet reminder
Clinical and legal language can read coldly at a hard time - we translate it for you.
If you would like us to talk your family through the assessment report and what it means before any meeting, just ask.
- 01 Header
Diagnosis and level of consciousness
Whether the findings indicate a vegetative state (unresponsive wakefulness), a minimally conscious state, or emergence - and the evidence behind it.
- 02 Assessment
Tools used and findings
Which validated assessments were carried out, how often, and the pattern of responses observed across the programme.
- 03 Findings
Reversible factors and imaging
What was reviewed and treated - medication, seizures, infection, posture - and how the brain imaging correlates with the clinical picture.
- 04 Plan
Prognosis, care and best interests
Read this first: the realistic outlook, the rehabilitation and care plan, the reassessment schedule, and support for any best-interests decisions.
Recognised by major UK insurers
Assessment and rehabilitation are often funded through NHS continuing healthcare, health insurance, or a personal-injury settlement coordinated by a case manager. We help families understand the options before anything begins.
Frequently asked
Everything families ask us about disorders of consciousness.
Quick answers on diagnosis, recovery, decisions, cost and funding.
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What is a prolonged disorder of consciousness?
It is a state of reduced or absent awareness that continues for an extended period after a severe brain injury. It covers the vegetative state - now often called unresponsive wakefulness syndrome, where a person has sleep-wake cycles but no clear signs of awareness - and the minimally conscious state, where there are definite but fluctuating signs of awareness. The term is generally used once the state has lasted at least four weeks, and careful assessment is needed to tell these conditions apart.
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Why can it not be diagnosed in a single assessment?
Signs of awareness in these conditions are often subtle, inconsistent and easily missed at the bedside. UK national clinical guidelines therefore call for repeated, structured assessments over weeks using validated tools such as the CRS-R, WHIM and SMART. Reversible factors like sedative medication, seizures, infection or poor positioning are also checked and treated first, because they can suppress responses and make a person appear less aware than they are.
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Can someone recover from a disorder of consciousness?
Some people do improve, and a proportion move from a vegetative to a minimally conscious state or emerge further, particularly after traumatic rather than non-traumatic injury and especially within the first months. However, the longer the state persists the lower the likelihood of significant recovery, and outcomes vary widely between individuals. A specialist gives an honest, individual prognosis based on the cause, the imaging and the pattern of responses, rather than a general figure.
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How are decisions about treatment made?
When a person cannot make decisions for themselves, choices are made in their best interests under the Mental Capacity Act, taking account of any previously expressed wishes and the views of those close to them. Decisions about clinically assisted nutrition and hydration are made with particular care and, in some circumstances, are reviewed by the Court of Protection. An accurate diagnosis is the foundation of any such decision, which is why structured assessment matters so much.
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How much does a private specialist assessment cost in the UK?
A rehabilitation medicine consultation is typically £300–£600, and a second-opinion diagnostic review £1,500–£3,500. A structured inpatient assessment programme over four to six weeks generally ranges from £18,000 to £45,000, and ongoing specialist neuro-rehabilitation is around £3,500–£8,000 per week. A best-interests or capacity report is roughly £2,000–£5,000. We confirm firm figures, and explain how funding usually works, within one working day.
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What is the NHS route, and how is care usually funded?
The NHS provides specialist assessment and rehabilitation for disorders of consciousness, often through regional neuro-rehabilitation services, and NHS continuing healthcare frequently funds long-term care. Private input is most often sought for a timely second opinion, a structured assessment when local capacity is limited, or as part of a personal-injury settlement where a case manager coordinates care. Some costs may be met by health insurance or litigation funding; we help families understand the options.
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