To refer to our services for an inpatient admission, please complete the inpatient referral form by entering all mandatory information and including all pertinent documents. Once complete, email to ASRU.referrals@middlemore.co.nz. Click here for the referral form. Acknowledgement of your referral will occur once the referral has been received. Once a referral is accepted for ASRU admission, the admissions co-ordinator will liaise with the referrer / acute team and identify the expected date of admission and the plan for transfer. The Inpatient Unit consists of 20 beds dedicated to short term spinal cord rehabilitation for patients aged 15 and older who have sustained neurological deficits from a spinal cord injury due to trauma, injury or illness. The interdisciplinary team includes rehabilitation medicine specialist, nurses, physiotherapists, occupational therapists, social workers, dietitians, psychologists and sometimes speech and language therapists who, with the client and their family, establish goals and an individual rehabilitation programme. Every person’s rehabilitation is aimed at gaining maximum independence and skills for reintegration into the community and into life roles. The team works closely with community and provider services such as ACC to ensure client needs are met and discharge planning is well coordinated. Once a patient is discharged the outpatient service provides lifelong support. Charges Clients admitted are usually covered by ACC or Ministry of Health funding, however we do also admit private or insurance funded clients. Patient information A patient information booklet is provided prior to arrival at the Auckland Spinal Rehabilitation Unit. This booklet provides useful information to assist the person and their family/whanau during their inpatient rehabilitation stay. See Patient & Family Information Booklet here ASRU Inpatient Referral Form (DOCX, 61 KB) version 2023 ASRU Inpatient Information Booklet (PDF, 20.2 MB) Version 2021

The Outpatient Service supports people affected by spinal cord impairment that live in the ASRU catchment area. We provide: An initial post discharge follow up review for people that have been inpatients at ASRU A range of general or specialty clinics following medical referral from your GP Health promotion, education and advice for people living with spinal cord impairment, their carers, health professionals, GP and ACC Discipline Specific Assessment & Treatment following referral We understand that people living with spinal cord impairment may have SCI related concerns throughout their lifetime. We encourage individuals living with SCI to first discuss these concerns with their GP. If SCI specialist review is required, we request a referral from their GP or case manager. General or Specialty clinics include: Team Assessments Medical Specialist Clinics Remote Assessments Spasticity Management Clinics Upper Limb Surgical Clinics Urology Assessment and Procedure Clinics Tele-health Phone or Video Consultation Team Assessment and Medical Specialist appointments may be offered in some locations outside Auckland. Team Assessments: This assessment includes a review by an interdisciplinary (IDT) team. The team consists of a Registered Nurse, Occupational Therapist, Physiotherapist and Rehabilitation Medical Specialist. The focus of the team review is on wellbeing and management of SCI related concerns through support, advice, education and recommendations to the individual living with SCI, their GP, ACC and health professionals involved in their care. A family member, healthcare provider or other support person is welcome to accompany the individual to this appointment. Appointments are usually 60-90 minutes long and a physical examination may be required. If an individual transfers using a hoist, it is recommended that they bring their own hoist sling to the appointment. Forms for ultrasound, blood and urine tests depending on individual need may have been sent prior to the appointment. These tests should be completed as soon as possible so the results can be discussed with the individual at the appointment. Medical Appointments: When an individual has a specific issue or medical complication associated with their spinal cord impairment, a medical appointment may be scheduled with a Rehabilitation Medical Specialist. Depending on the nature of the appointment, ASRU Nursing or Therapy staff may also be involved. Appointments are usually 45-60 minutes long. A physical examination may be required. Remote Assessment: Remote reassessments can be offered as a form of patient review. This is used to collate and gather more information about an individual’s spinal injury related concern. These assessments involve a questionnaire being sent to the person initially. Following completion and receipt of this, a clinician phones the client to discuss specific issues or to follow up previous recommendations. Spasticity Management Clinics: These clinics aim to optimise safety, function and independence for people with spinal cord impairment through spasticity education and management by our Rehabilitation Medicine Specialist and an ASRU therapist. Appointments are usually 60 minutes long and a physical examination is required. This clinic is currently only available in Auckland but open to all in our catchment area that are able to travel to Auckland. Upper Limb Surgical Clinic: The Upper Limb Surgical Clinic is held with surgeons and ASRU Therapists for individuals with tetraplegia to assess for potential surgical options to help improve upper limb function. An upper limb physical assessment is completed and possible surgical options are discussed. Education about the surgeries and rehabilitation post-operatively is provided with a client-centered approach. Surgical planning and clinic follow up is arranged as appropriate following the clinic assessment. Urology Assessment and Procedure Clinics: ASRU provides an outpatient urology service for the majority of clients with SCI living within the greater Auckland region. Clinics are held at ASRU for consultation and Manukau Surgery Centre for urological investigation procedures. Individuals living outside Auckland may be referred to their local DHB urologists for follow-up. Tele-health Phone or Video Consultation: A telephone or video consultation service in some circumstances may be available for people who have a scheduled appointment with Rehabilitation Medicine Specialist or the ASRU Outpatient Team. How to refer to the Outpatient service: If an individual has a SCI related concern, their GP will need to provide a referral to be seen. GPs within Auckland are able to refer to ASRU via e-Referrals. For GPs outside Auckland, ACC and other Health Professionals please complete the Outpatient Referral Form and send via email to Need to reschedule an appointment? If unable to attend a scheduled appointment or there is a need to reschedule, please contact our Outpatient Scheduler by phone: (09) 270 9000, 0800 774 642 or email: To be seen by ASRU Nursing and Therapy teams, we request a referral. For ACC funded individuals this referral will need to be sent by ACC. Please send referrals via email to ASRU Outpatient Referral Form (DOCX, 51.8 KB) version 2023

ASRU provides an outpatient Urology Service for the majority of clients living within the greater Auckland region. Individuals living outside Auckland may be referred to local urologists for follow-up. Outpatients are seen at the ASRU or at the Manukau Surgery Centre. Referrals from GPs and healthcare professionals can be sent to the ASRU for urology review.

Food and nutrition plays an important role in the rehabilitation process and long-term health of people with spinal cord injuries. Immediately following injury significant weight loss and alterations to body composition is common making the person vulnerable to low energy levels and pressure ulcers. During and after the rehabilitation phase healthy eating is essential for maintaining a healthy weight and minimising the higher risk of obesity, pressure ulcers, bladder and bowel problems, diabetes and heart disease. Who we are: We have a NZ Registered Dietitian on site 2-3 days each week. Dietitians are experts in nutrition who provide treatment, education and support in order to improve health outcomes. They apply scientific knowledge about food and nutrition to individuals and groups. Dietitians must be registered to practice under the Health Practitioners Competence Assurance (HPCA) Act 2003 and abide by a code of ethics. How is a dietitian different from a nutritionist? Dietitians are uniquely qualified in clinical nutrition and so can manage the nutritional care of people in disease as well as health, in a variety of health settings. They are registered health professionals who are required to meet standards of professionalism under the NZ Dietitians’ Board. They have completed a postgraduate qualification in Dietetics and must abide by a code of ethics and participate in a continuing competency programme that includes regular audit. What we do: Inpatients at the spinal unit are provided with the opportunity to improve their nutritional status and to learn about the nutritional management of spinal cord injury. This includes: Nutrition assessment, intervention and follow-up as required Provision of nutritional supplements, enteral feeds and special diets as appropriate Group and individual/family/whanau education Referral criteria: All inpatients are assessed by the dietitian following admission.

Nurses are registered health professionals and all hold current registration with the Nursing Council of New Zealand (statutory authority) which governs the practice of nurses. The Council sets and monitors standards in the interests of the profession. The Council's primary concern is public safety. The nursing team consists of Registered Nurses, Enrolled Nurses and Health Care assistants and are supported by the Charge Nurse, Nurse Educator, Clinical Nurse Specialist (outpatients), Rehabilitation Coordinator and Admission Coordinator. Nurses provide a comprehensive nursing assessment of patients who have sustained a spinal cord injury. Following assessment the nurse will work alongside the patient, their family/whanau and the ASRU team to establish patient centred goals. Together, the patient and the interdisciplinary health care team participate in achieving and evaluating these goals, which will allow the patient to achieve the very best outcomes in terms of health, independence and function, thereby improving quality of life. Nurses involved in rehabilitation also have a large teaching role. Spinal cord injury can affect essentially all body parts and functions below the injury leading to difficulties with skin integrity, sexual function, bowel and bladder function, blood pressure and circulation, breathing and balance. Nurses assist patients to practise new skills and provide education to help them to regain and maintain their health and wellbeing.

What is Occupational Therapy? Occupational Therapists are registered health professionals. Their goal is to help people live independent, productive and satisfying lives. They do this by helping people develop, relearn, and maintain daily living and work skills. Occupational Therapists also help caregivers, families, friends, teachers and employers to understand and learn how to support individuals with disabilities, so that the person living with a spinal cord injury can maintain or increase their independence. The word "occupation"’ in occupational therapy refers to the activities and tasks that we all do every day. Occupational therapists assist people to perform activities of all types, ranging from using a computer to daily needs such as dressing, cooking and eating. What does an Occupational Therapist do? Occupational Therapists assess each person by interviewing them (and maybe members of his/her family/whanau) to understand their perspective of the functional concerns associated with the SCI and by observing activities the person usually does and how they are now managing. Interventions may include: helping to break activities into smaller steps teaching new or different ways of doing old activities teaching others new or different ways to help group or individual work assessing the need for, and where necessary, prescribe specialised equipment and/or housing modifications so that the person can manage their usual daily activities stress management play, leisure or recreation activities exercises to increase strength and dexterity advice on healthy living especially related to living with a chronic illness or disability provide specific information to help a person achieve their goals. Our team provides both an Inpatient and an Outpatient service. For inpatients our focus/aims are on rehabilitation, determining equipment and home needs, community support needs and establishing links within the person’s community in order to return them to independent living with or without supportive services. Our Outpatient service covers: wheelchair and seating assessment, reviews splinting hand therapy training for independent living programmes (ACC only) pressure care education and management assessment of activities of daily living. Appointments with our Outpatient team are available from Monday - Friday, 8am to 4pm. The outpatient team covers predominantly the South Auckland region; however we will see patients in the greater Auckland area if indicated and on a case by case basis. For referrals click here

What is Physiotherapy? Physiotherapists are registered health professionals and all hold current registration with the Physiotherapy Board of New Zealand. What does a Physiotherapist do? Physiotherapists assess each patient with an interview and a physical assessment. Clients' goals for therapy are discussed and a plan is put together in order for the client and therapist to work towards achieving the identified goals. Interventions may include: implementing stretching regimes strength training and setting up strengthening programmes practice of functional activities i.e. transfer training (this often includes breaking the activity down into components) balance retraining exercise classes wheelchair skills training and classes gait/walking retraining (as appropriate) hydrotherapy (water-based therapy) passive standing on tilt table and/or in standing frame respiratory physiotherapy (as indicated) functional electrical stimulation (FES) walking, standing and exercise equipment prescription. Outcome measures/assessments are routinely used as part of physiotherapy. These provide clients and therapists with feedback regarding improvements and help guide achievement of the person’s goals. Our team provides both an Inpatient and an Outpatient service. Our Inpatient service focus/aims are to teach people living with SCI tasks, techniques and skills in order to be as safe, independent and mobile as possible. Our Outpatient service covers clients who are referred for mobility and functional goals. Clients may be ACC or Ministry of Health funded. Clients are prioritised and placed on a waiting list.

We are a team of qualified social workers who are committed to a practice that reflects an understanding of the Treaty of Waitangi and adhere to the Aotearoa New Zealand Association of Social Workers Code of Ethics and Bi-cultural practice. We can provide assistance to individuals and their family/whanau who may need support with issues related to the changes in their physical abilities, to their hospital stay, their discharge planning and their living back in the community. Social Work Services include: Support: you may want to discuss lifestyle changes the effects of your hospital stay on you or your family concerns at home or work drug and alcohol issues family violence other issues affecting you. Advocacy and information: we can assist you to gain information and access to services appropriate to your needs find key supports in the community access information regarding consumer rights and health and disability education. Discharge planning: we can assist with your planning for discharge to the community Options to consider include: caregiver support and practical assistance on discharge safety concerns temporary accommodation while modifications are being made to your home Housing New Zealand applications for modified housing moving to residential care liaison with other health services referral to community services. Outpatients / Outreach work Providing ongoing support about social work issues Providing information on potential networks that exist in your area or region Ensuring that you continue to get your entitlements For referrals click here. Community Social Services A lot of information is given to patients during their inpatient stay that can sometimes be overwhelming, somewhat “information overload” or not relevant until faced with the reality of returning to the community. The Community Social Services Directory is a resource of key contacts details and sources of information that has been compiled for people with a spinal cord injury or spinal cord condition, their families, carers and health professionals to provide useful contacts for services which can assist in the transition from rehabilitation back into the community. It covers topics like Financial Support, Budgeting Assistance, Housing/Accommodation/Home Ownership, Home Health Care Providers, Advocacy/Support, Disability Information, Community Supports, Sports & Recreation, Transport/Travel, Vocational employment and Useful Links. Please note that this directory/booklet is not intended to be a complete guide to ALL services. We welcome feedback from anyone regarding additional services, updated information and any changes to the following contact details via the Outpatient Social Work Service at Auckland Spinal Rehabilitation Unit.

Websites & Email Addresses Accident Compensation Corporation Counties Manukau Health Burwood Hospital Burwood Academy of Independent Living Catwalk - email info@catwalk.org.nz Disabled Persons Assembly Mobility Dogs NZ Association of Occupational Therapists NZ Spinal Trust Occupational Therapy Board Office of Disability Issues Glenn Family Foundation Trust Sex, Intimacy & Spinal Cord Injury Forum Spinal Essentials Spinal Support New Zealand The Auckland Paraplegic & Physically Disabled Association Inc Occupational Therapy Occupational Therapy Board of New Zealand New Zealand Association of Occupational Therapy Physiotherapy Physiotherapy Board of New Zealand Other Resources ASRU Patient and Family Information Booklet Community Social Services

NZ Spinal Trust: The NZ Spinal Trust programme is dedicated to getting people who happen to be living with a disability into jobs that they love. Spinal Support NZ: Also known as the “Buddy Organisation”, Spinal Support’s main function is to inform, encourage and motivate people with spinal cord impairment. Spinal Support also have vans to hire for outings and leave. Please check with their office for details. Free budgeting advice is also available and in the Auckland area the discounted Total mobility taxi can be applied for through Spinal Support at a cost of $10.00. Disability Sport Auckland: (Paraplegic and Physically Disabled Association): Disability Sport Auckland focuses on Rehabilitation with a strong emphasis on sport, they organise sports and recreation events for many different skill levels.