Why INS is so needed Who is INS? INS is an innovative registered charity providing long-term support to people and their carers with a neurological condition such as: multiple sclerosis (MS), Parkinson’s disease (PD), and Stroke. Having a neurological condition often leads to reduced communication skills and self-confidence and a loss of mobility. This can mean that people are unable to go out and therefore, become isolated at home or within a limited environment – as do their carers. This often results in depression, loneliness and a further loss of self-esteem for both sufferers and carers. The need for us INS clients will not get better, their conditions are life-long, often severe, sometimes their presentation is up and down and often they have reduced life expectancy. INS’s work reduces loneliness and depression which contributes to improved well-being in our clients and carers. Comments from clients include: “I wouldn’t be here talking to you today if it weren’t for INS”; “I came in shuffling and I came out striding”; “I love it. It pulled me out of a very dark hole.” After providing acute hospital care, the NHS can only fund limited support in the community for a few weeks for people with these conditions – after that people are left to cope on their own. Patients with neurological conditions have the lowest health related quality of life of any long-term condition. At INS we use a holistic approach to deliver a range of integrated clinical services and social and emotional therapeutic support. A key outcome of our services is to enable people to remain as active as possible to ensure that they stay engaged with their communities, do not become isolated from their social networks and to enable them to develop new connections that can support both their physical and emotional needs. INS employs a multi-disciplinary team (MDT) providing physiotherapy; occupational therapy (OT); speech and language therapy (SLT); counselling; and social work (SW) support. Therapy assistants and administrative staff also form an essential part of the MDT which is supported by an experienced team of skilled and dedicated volunteers. Clinical services are delivered in group therapy sessions and also one on one. Support services are run as group activities and include social outings, social groups and carer activities. To support people to undertake activities that they may not usually have a chance to try out, or lack the confidence or means to access, we run an ‘Expanding Horizons Programme’ where we take our clients on different community activities ranging from, archery to art, tai chi to ten pin bowling as well as boat trips, horse-riding, gardening and cultural visits. These expand peoples’ ideas as to what they can get involved in and in many cases, they continue to take part after our initial introduction. This is a very effective way to reduce a person’s loneliness and isolation as by trying out new hobbies and interests, they meet new people and have a motivation to leave their house. We accept self-referrals, carer referrals and referrals from health and social care professionals. Unlike the NHS or social services, INS provides its services for as long as they are required. We do not limit the number of sessions we provide or have a time limit on how long a person can access our services for. Services are delivered at our base in Twickenham, SW London, in client’s homes, or in their local environments such as parks and community resource centres. Currently, INS provides services for 391 clients and carers across two London boroughs – Hounslow and Richmond. Many of our clients – and their carers – are socially isolated and experience loneliness due to communication problems and motor or sensory impairments. This can limit their ability to keep in touch with their previous social connections developed before the onset of their condition. Some clients have cognitive impairments which lead to social and environmental barriers to effectively engage with their local community. Other clients lack confidence to access local services or engage in social activities. Carers may be too exhausted to maintain or build community connections or simply not be aware of how to reduce their loneliness. Our speech and language therapy service improves communication skills, teaching clients new strategies to manage challenges, or teaching carers better listening and understanding skills. Our physiotherapy service improves client’s mobility, reduces the fear of falling and increases clients and carers’ stamina. Our social workers provide social contact and vital information on accessing local services and statutory benefits and introduce befrienders to lonely clients. At INS our holistic approach enables us to recognise that barriers leading to loneliness are not just physical; they are cultural, financial, psychological and social. We recognise that although not all barriers can be removed; they can all be reduced.