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Post-ICU rehabilitation - the recovery critical care forgot to plan.

A specialist programme for survivors of intensive care. Muscle wasting, cognitive fog, breathlessness, nightmares and the fatigue no one prepared you for - addressed by an ICU-experienced rehab consultant, physiotherapist, occupational therapist and psychologist.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What post-icu rehabilitation costs privately in the UK.

Indicative ranges across our partner units.

In short

£4,800–£11,000, home or residential.

Procedure Indicative range
Post-ICU consultant assessment £450–£750
ICU rehab bundle re-assessment £220–£380
Respiratory physiotherapy (per session) £95–£165
Home rehab visit (per session) £140–£240
Six-week post-ICU outpatient programme £4,800–£8,500
Residential post-ICU rehab (per week) £5,500–£11,000
ICU trauma psychology (per session) £150–£260

Prices vary by hospital, by the consultant, and by complexity.

The problem

ICU saves lives. The recovery is a second illness.

Survivors are discharged from hospital when they are medically safe - not when they are functionally ready. The gap is called Post-Intensive Care Syndrome, and it needs its own plan.

  • ICU-acquired weakness is real and measurable

    A week of critical illness costs 15–20 percent of quadriceps mass. That is not deconditioning - it is a specific myopathy and neuropathy that needs graded, resistance-based recovery.

  • The cognitive fog is not "just tiredness"

    Delirium in ICU predicts long-term cognitive change. Up to a third of survivors have impairment that looks like early dementia at three months. It responds to structured cognitive rehab.

  • PTSD, nightmares and flashbacks are common

    Around one in five ICU survivors develop PTSD. Screening, ICU diary work and trauma-focused therapy are part of a proper programme - not a referral six months later.

When it helps

When post-icu rehabilitation is the right step.

The situations we see most, plus the one red flag that means treating something else first.

  • ICU-acquired weakness

    Difficulty standing, climbing stairs, opening jars - muscle wasting from prolonged critical illness. Responds to graded, criterion-based resistance work.

  • Cognitive fog and memory change

    Word-finding difficulty, poor concentration, forgetfulness - often at return-to-work stage. Structured cognitive rehab and pacing.

  • Persistent breathlessness

    After ARDS, severe pneumonia, COVID or long ventilation - respiratory retraining, inspiratory muscle work and graded aerobic exercise.

  • Post-ICU PTSD and nightmares

    Intrusive memories from ICU, flashbacks and sleep disruption. Trauma-focused psychology and an ICU diary re-visit.

  • Post-tracheostomy voice and swallow change

    Hoarseness, altered swallow, tracheal stenosis - SLT-led rehab, ENT review where indicated, and a graded voice programme.

  • Post-sepsis fatigue and low mood

    The fatigue that lasts months after "surviving" - a pacing programme, psychology, and treatment of the depression that often follows.

  • Family caregiver burden

    PICS-Family - spouses and children develop anxiety, depression and PTSD too. Family debrief, education and psychological support are part of the plan.

  • Red flag: new or worsening breathlessness

    Sudden breathlessness, chest pain, calf swelling, high fever or new confusion means A&E, not the next session. Post-ICU patients have higher DVT and readmission risk.

Programme elements

A post-ICU programme has more moving parts than standard rehab.

The eight elements a proper post-ICU recovery plan should contain - most units miss at least three.

  • ICU rehab bundle assessment

    Grip strength, MRC sum-score, sit-to-stand, six-minute walk, MoCA, HADS and PTSD screen - the baseline every four weeks.

  • Respiratory retraining

    Inspiratory muscle training, diaphragmatic breathing, graded aerobic work - for ARDS, prolonged ventilation and post-COVID survivors.

  • Progressive resistance training

    Low-load, high-repetition starting below perceived limit - building against measured grip and quadriceps strength, not against calendar days.

  • Cognitive rehabilitation

    Attention, working memory, executive-function tasks and compensatory strategies - with a graded return to reading, screens and work.

  • ICU trauma psychology

    Trauma-focused CBT or EMDR for PTSD, screening for depression and anxiety, and an ICU diary review with the family.

  • Sleep and fatigue management

    Sleep hygiene, medication review, pacing plans, and screening for sleep-disordered breathing - very common after long ICU stays.

  • Nutrition and muscle support

    Dietitian input on protein intake, vitamin D, iron and B12, plus screening for refeeding risk in the first month after discharge.

  • Family debrief and PICS-Family support

    Structured session for the spouse or key relative - explanation, screening for PICS-Family, and signposting where they need support of their own.

Safety and recovery

What to expect afterwards - honestly.

A well-established treatment. The things worth planning are the approach, the recovery, and knowing the honest risks.

  • Assess before every session

    Blood pressure, oxygen saturation, symptom check and - for tracheostomy patients - cuff and secretion review. Fatigue on the day changes the session, it does not stop the programme.

  • Post-ICU DVT and PE risk stays high for months

    Immobility, systemic inflammation and central lines all raise clot risk. New calf pain, swelling or breathlessness during rehab is a same-day medical call, not the next appointment.

  • Do not chase pre-illness numbers too soon

    Overloading a wasted quadriceps triggers reinjury and delays recovery by weeks. Progression is criterion-based on measured strength, not on how you feel that morning.

  • Cognitive load matters as much as physical

    Reading, screens and problem-solving all draw on the same reserve. A proper programme paces both - most patients need a graded screen-time plan, not just an exercise chart.

  • PTSD triggers can appear months in

    Alarms, hospital smells, family conversations about ICU can all set off intrusive memories. We warn you, screen quarterly, and treat when it appears - not when it worsens.

  • Nutrition and refeeding risk in the first month

    Prolonged critical illness leaves nutritional deficits. Protein, vitamin D and B12 are checked and corrected; refeeding syndrome risk is screened where relevant.

  • Medication clean-up

    ICU patients leave on a long medication list - sedatives, painkillers, PPIs and antibiotics that are often no longer needed. A pharmacist reviews and streamlines at the first visit.

  • Family caregivers need care too

    PICS-Family is real. Spouses and children have measurable rates of anxiety, depression and PTSD. Structured family debrief and signposting is part of the programme.

  • Red flags after critical illness

    New confusion, worsening breathlessness, chest pain, calf swelling, high fever, blood in cough or urine, or a sudden step-down in function all mean A&E and a call to the team.

Reading your notes

Your post-ICU plan in four parts. Read the last one first.

Whichever pathway you take, the written plan the consultant sends you keeps to the same shape - designed for critical-care survivors.

A UK consultant reviewing a post-ICU recovery plan

A quiet reminder

Clinical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the notes before your review, just ask.

  1. 01 Header

    ICU admission, PICS features and pathway

    The ICU story in plain English - reason, length, ventilation, delirium, tracheostomy - and the PICS features present now.

  2. 02 Team

    Who is doing what, and when

    The rehab physician, respiratory physio, OT, psychologist, dietitian and pharmacist involved, with contact points and weekly meeting slot.

  3. 03 Findings

    ICU rehab bundle results and trend

    Grip strength, MRC sum-score, sit-to-stand, six-minute walk, MoCA, HADS and PTSD screens - baseline, monthly and trajectory.

  4. 04 Impression

    Progression rules, family debrief and discharge

    Read this first: what triggers a step-up, the family debrief plan, the criteria for discharge and the route back if any PICS symptom returns.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Post-ICU rehabilitation is usually covered where PICS is documented and the programme is consultant-led with a written plan. Residential admission and clinical psychology often require pre-authorisation.

Frequently asked

Everything we get asked about post-icu rehabilitation.

Quick answers on PICS, timing, family support, cost and insurer cover.

  • What is Post-Intensive Care Syndrome (PICS)?

    PICS is the umbrella term for the new or worsened physical, cognitive and psychological problems that persist after an ICU admission. Physically: ICU-acquired weakness, breathlessness, fatigue. Cognitively: attention, memory and executive-function change. Psychologically: PTSD, depression, anxiety, sleep disturbance. Around half of ICU survivors have at least one PICS feature at three months, and many still have some at a year.

  • How is post-ICU rehab different from standard physiotherapy?

    Standard physiotherapy treats one system - usually musculoskeletal or respiratory. Post-ICU rehab treats the whole PICS picture: physical, cognitive and psychological, delivered by a team that understands what happens on ICU. A quadriceps that has lost 20 percent of its mass in a week does not follow the same progression rules as one that has been resting after a knee operation.

  • When should post-ICU rehabilitation start?

    Ideally within two to four weeks of hospital discharge - early enough to catch weakness and fatigue before habits harden, late enough that you have some baseline energy. If you were discharged more than three months ago and still feel worse than expected, it is not too late - PICS responds to structured recovery even a year later.

  • How long does the programme run?

    A typical outpatient programme runs 6–12 weeks with two to five sessions per week. Residential programmes run 2–4 weeks. Full recovery can take 6–12 months and sometimes longer - the programme sets a self-management plan for the year after discharge so you do not have to think about it session by session.

  • Will my family also need support?

    Often yes. PICS-Family describes the anxiety, depression and PTSD that spouses and adult children of ICU survivors develop at measurable rates. A family debrief is part of the programme, and we signpost anyone who needs support of their own.

  • How much does private post-ICU rehab cost in the UK?

    Roughly £450–£750 for the consultant assessment, £95–£240 per session depending on setting, £4,800–£8,500 for a six-week outpatient programme and £5,500–£11,000 per week residential. A firm quote follows the ICU rehab bundle assessment.

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