Murdostoun Brain Injury Rehabilitation and Neurological Care Centre has built a reputation for supporting patients across Scotland with specialist neuro-rehab and care. With the appointment of Dr Ales Praznikar as medical director, the ongoing development of both the centre’s services and team is set to advance further still. NR Times learns more.

Before joining Murdostoun as its medical director, Dr Ales Praznikar served as the clinical lead for the neurorehabilitation unit at Queen Elizabeth University Hospital in Glasgow.

With Queen Elizabeth University Hospital being one of Murdostoun’s main referrers, Dr Praznikar was already familiar with the facility and had engaged with the team there on numerous occasions before his transfer.

The level of interaction between the Murdostoun team and the neuro-rehab team at Queen Elizabeth University hospital, as well as the preparation from both teams, enabled numerous patients to successfully transfer from an acute to a residential setting. The incredible care delivered in the residential setting at Murdostoun was an important factor in Dr Praznikar’s decision to join their team.

“We referred quite a lot of patients to Murdostoun, and I also visited the facility, because I wanted to see where the patients were being referred to,” says Dr Praznikar.

“It was a very good team. They would send me a report of every patient that we referred, and they were very nicely done.

“I was familiar with the quality of the facility well before I came here. It is a well-run centre, and I am really pleased to have joined the team here at Murdostoun as medical director.”

Dr Praznikar has a highly respected track record for his clinical work, including his previous role as the director of the International Alliance for ALS/MND and membership to the European Academy of Neurology Scientific Panels for neuro-rehabilitation and neuropathic pain.

Aside from his experience, he is a renowned leader, committed to service and staff development alike. The addition of Dr Praznikar to Murdostoun’s neuro-rehab team shows Active Care Group’s dedication and investment to further develop and improve their services.

As such, plans are being looked at for the expansion of Active Care Group-owned Murdostoun - both in terms of capacity and new provision for certain conditions, as well as involving the team in research projects. This will support the further development of the capability and reputation of this specialist 46-bed North Lanarkshire site, which supports people with neurological injuries and illnesses from across the West of Scotland and the wider country.

Committed to achieving best outcomes

For many years, Murdostoun has had a reputation as a key provider of neuro-rehab and neurological care for patients primarily from the Greater Glasgow and Clyde NHS area, but across the wider country too.

Set in a rural location with expansive gardens, Murdostoun comprises a brain injury rehab unit - which supports survivors as soon as they are medically stable and are able to work with complex patients, such as prolonged disorders of consciousness, functional neurological disorder and those who have a neurological condition requiring a tracheostomy.

There is also a neurological care unit - which provides both long-term, including slow-stream rehab provision. Both sites can provide respite and complex needs care.

For all patients and their unique needs, the Murdostoun team is committed to delivering the best possible outcomes, whatever the circumstances.

One patient, 47-year-old Scott, was admitted to Murdostoun for long-term care after sustaining brain injury in an assault in 2010. He also has a history of drug and alcohol misuse. He had seen the breakdown of many relationships and people losing faith in him, causing Scott to feel “stuck in life”.

Although he often finds social situations very challenging, the Murdostoun team were determined to help him manage that as much as possible, as well as helping him achieve his long-held ambition of working in hospitality.

Through working with him over the course of many months and years, the right rehab and support has seen huge progress for Scott. Having secured a place on the Social Inclusion Project - an initiative dedicated to creating a diverse society where people have opportunities for inclusion - Scott also secured his dream job in the process.

Since October 2022, Scott works one morning each week in a local coffee shop, with duties including serving customers and food preparation. Scott has thrived since taking on the position, making new friends at the coffee shop and relishing his new-found independence.

He even joined the staff Christmas lunch last year, something his rehab team say was previously beyond all expectations for Scott.

“I finally feel like I have some purpose,” says Scott.

“I have found my passion working in the food industry.”

Scott’s case helps to articulate the Murdostoun team’s commitment to help patients achieve their ambitions - and clearly shows the efficacy of the goal setting process, says Dr Praznikar.

“We work with patients to set goals, but this process depends on the individual and what goals are set based on their rate of improvement,” he says.

“The set goals must be felt as achievable by the patient, their families and friends, and the team. This case is a good example of what can be delivered and achieved.”

Service development

With an in-house rehab team, and specialism in a host of complex needs, including spasticity management; PEG feeds and skin integrity problems, Murdostoun has the capability to support patients with a wide range of neurological needs.

With Dr Praznikar’s long-standing specialty in more complex cases, Murdostoun is looking to potentially develop and introduce support programmes for patients with particularly challenging needs, to build on the centre’s and its staff work even further.

“We have some sub-specialty programmes for especially complex patients,” says Dr Praznikar.

“Such as patients with prolonged disorders of consciousness (PDOC), patients with tracheostomy, complex stroke patients and those with spinal cord pathology.

“In some of the programmes, like PDOC, there have been a lot of advancements recently in basic science and clinical science, which means it needs to be looked at as almost a sub-specialty clinical approach.”

The Murdostoun team have developed their patient support systems in both the brain injury rehab and neurological care disciplines over many years. While they are already accustomed to dealing with the most complex cases - an area that could be developed further still - the principles of engaging each patient in rehab and support are the same, says Dr Praznikar.

“We take any patient with neurological dysfunction, and that is what neurorehabilitation is all about. At Murdostoun it is our goal to treat all patients with these conditions,” he says.

“The basic concepts are the same for everyone. We admit patients when we believe that the team’s approach can improve a patient's functioning in any of the domains, be that physical, cognitive, emotional, or social.

“It might be the particularities of treatment might be different, perhaps additional treatments like pharmacology, but the basic concept is the same - we want to support people with a neurological dysfunction or dysfunctions in order to improve their lives.”

Team development

The team at Murdostoun is well known for their capability and commitment, which attracted Dr Praznikar to the site prior to joining. Now, he is keen to use his extensive experience in leadership and development to help support the progress of team members.

“I think the team is excellent and has potential for further development and they are committed to participate in developing their skills,” he says.

While training and skills development remain a key part of Active Care Group’s ethos and commitment to their staff, Dr Praznikar would particularly like to focus on and advance their involvement in research.

“We would like to start several research projects, which would really help the team to develop,” he says.

“They have experience in this already, especially within the neuropsychology programme, where there has been some research going on.

“I have started to make it more structured and [an] almost a regular part of the clinical work. It will be organised as part of this, we will be clear about how to manage and achieve the outcomes.

“I believe that research and the data can contribute to the treasury of knowledge, in a way that is necessary to the inherent part of clinical work.

“It’s a team effort and an area we can involve the team for their development, and for the development of our service.”

To find out more, please visit activecaregroup.co.uk