Rachael Joyce
London
Summary
Experienced Principal Physiotherapist specialising in complex neurological and vestibular disorders. Expert in clinical assessment, diagnosis, and tailored treatment plans, including the INVEST approach for PPPD. Engages in multidisciplinary collaboration and service development through evidence-based initiatives. Provides clinical supervision and leads teams while contributing to national and international Vestibular Rehabilitation Courses.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Principal Physiotherapist - Neuro & Vestibular Outpatient Department
St George’s University Hospitals NHS Foundation Trust
08.2025 - Current
- Managed Neuro and vestibular outpatient department clinically and operationally in collaboration with job share partner.
- Facilitated first contact practitioner clinic to evaluate and treat BPPV while addressing patients' fall risks.
- Advanced clinical assessment and rehabilitation skills in managing highly complex neurological and vestibular disorders. including atypical benign paroxysmal positional vertigo (BPPV), central vestibular disorders, vestibular migraines, persistent postural perceptual dizziness (PPPD) and other functional balance disorders.
- Trained to deliver the INVEST approach, which is psychologically informed rehabilitation for patients with PPPD
- Collaborated with neurologists, clinical nurse specialists, audiovestibular consultants, neuro-otologists, audiologists, and clinical scientists to deliver comprehensive treatment plans.
- Supervising, initiating and participating in evidence-based projects, including recommendations for change in practice and leading the departmental audit in the clinical area
- Initiated changes within the team and area, while monitoring standards.
- Working collaboratively to effectively run out neurological services across the trust
- Supported recruitment and staff retention initiatives to enhance team stability and service delivery.
- Authored ‘Psychologically Informed Vestibular Physiotherapy Using the INVEST Approach for Persistent Postural Perceptual Dizziness: A Case Report’ with Elizabeth Wood, PT, PGCert, and Rachael Joyce, PT.
Highly Specialised Rotational Neurological Physiotherapist
St George’s University Hospitals NHS Foundation Trust
05.2023 - 08.2025
- Clinical team lead of various services including Neuro & Vestibular Outpatients, Acute Stroke and rehabilitation service, Neurosurgery, Neurology, Neuro Rehabilitation and Neuro Outreach.
- Clinical and managerial responsibility of services
- Highly specialist and analytical clinical assessment and analysis of neurological presentations and neurological gait, creating, planning and advising on specialised treatment plans, consisting of numerous adjuncts to support therapeutic handling, including functional electrical stimulation, orthotics, exercise prescription and spasticity management for holistic patient care, linking in with external services appropriately
- Organising and prioritising a designated caseload of Neurological patients and delegating appropriately
- Clinical and managerial supervision of junior staff including technician and students
- Active involvement in staffing and recruitment
- Continual analysis of posture and movement in more in depth and development of therapeutic handling skills
- Completion of clinical audits for upper limb stroke patients and a service development project implementing the Stroke Upper Limb Clinic, whilst supporting the implementation of the Acute Vestibular pathway.
- Active involvement in teaching on internal, external and international courses
Clinical Specialist Physiotherapist – Gait Laboratory
St George’s University Hospitals NHS Foundation Trust
06.2022 - 05.2023
- Clinical lead and management of tertiary FES Service
- Physiotherapy lead for Clinical gait analysis inc. Neuro, Paeds, Amputee services
- Advanced examination skills and the knowledge to collect and analyse kinematics, writing comprehensive gait analysis reports to present to multicentre MDT’s with onwards recommendations. These recommendations included suitability for surgical intervention, exercise prescription, spasticity management, orthotics and prosthetic adjustments.
- Production of comprehensive clinical gait analysis MDT reports
- Presented regularly at multi centre MDTs
- Development of Wolfson IP clinical gait analysis service
Specialised Rotational Neurological Physiotherapist
St George’s University Hospitals NHS Foundation Trust
01.2018 - 06.2022
- Neurosurgery and Neuro ICU involving traumatic head and spinal cord injuries, Hyperacute and acute stroke unit, Neuro rehabilitation, Community Neuro Team, and Prolonged Disorders of Consciousness.
- Acute management and rehabilitation of a wide variety of neurological conditions: Spinal Cord Injuries, traumatic brain injury, stroke, Guillan Barre, Miller Fischer, Myasthenia gravis, peripheral neuropathies and Parkinson's.
- Management of acute spinal cord injuries and respiratory complications in neuro muscular conditions or following a neurological event
- Competent in tracheostomy management and active role in weaning programme.
- Organising and prioritising a designated caseload of Neurological patients and delegating appropriately
- Developed acoustic neuroma pathway for neurosurgical patients from acute care to outpatient management, focusing on assessment, treatment education, and post-operative care.
- Collaborated with patients and families throughout rehabilitation to facilitate comprehensive discharge planning.
- Spasticity management with close liaisons with Extended Scope Practitioner
- International teaching - Training provided on NICU and stroke rehabilitation in Vietnam – Phu Tho Hospital – Service development and rehabilitation
- Supervised physiotherapy assistants and junior physiotherapists, improving team dynamics and quality of patient care.
- Organisation of CPD for all Neurological Physiotherapists at SGH
- Presenting at ACPIN 2021 Conference - A case study demonstrating the effect of neurorehabilitation for Mononeuritis Multiplex post Covid-19; improving function, reducing care costs and preventing the need for surgery
Band 6 Rotational Physiotherapist
Kings College Hospital NHS Foundation Trust
08.2016 - 01.2018
- Sixth monthly rotations in accident and emergency, AMU, CDU, Intensive Care Unit, respiratory, including amputee care and Elderly Care.
- Assisted in the setting up of a new service for the management of elderly care rehab
- Experience in complex posture and seating assessments neurological patients and the subsequent prescription of appropriate wheelchairs to suit their specific postural needs.
- Opportunity to analyse posture and movement in more in depth and develop therapeutic handling skills
- Established and implemented training around the acute assessment and treatment of vestibular patients in A&E
- Worked with a multicultural community, demonstrating ability to clearly communicate complex and sensitive information to patients and families.
- Part of the respiratory emergency on call rota
- Participate in weekend A&E rota – 7 day service
Band 5 Rotational Physiotherapist
North Cumbria University Hospital NHS Trust
06.2015 - 07.2016
- Sixth monthly rotations in Musculoskeletal outpatients, General intensive care, surgical/respiratory and HASU including specialities of Head and neck and amputees.
- Created evidence based patient information leaflets for ACL reconstruction, Spinal Surgeries and total shoulder replacements.
- Participated in weekend medical and neurological services
- Participated in the respiratory on-call rota
- Clinical educator to students
- Development of managerial skills including deputising in absence of senior staff.
Band 5 Bank Rotational Physiotherapist
Cumbria Partnership NHS Foundation Trust Bank
05.2015 - 06.2015
- Triaged, assessed, and treated patients from GP referrals, self-referrals, and post-operative referrals, ensuring timely access to care
- Developed and implemented outpatient group exercise programme, promoting patient engagement and recovery
- Completed one-month bank post in musculoskeletal outpatient clinic, enhancing service delivery during high-demand period
Education
MSc (Pre-Reg) - Physiotherapy
Northumbria University
Newcastle upon Tyne01-2012
Bachelor of Science - Sports and Exercise Science
Leeds Metropolitan University
Leeds01-2015
Skills
- Vestibular rehabilitation
- Neuro rehabilitation techniques
- Clinical assessment and diagnosis
- Gait analysis
- Evidence-based practice
- Clinical audit expertise
- Multidisciplinary collaboration
- Faculty member of Vestibular Rehabilitation courses nationally and internationally
Membership Of Professional Bodies
- Health Professions Council, PH106238
- Chartered Society of Physiotherapy, 098929
Certification
Course Qualifications
· UCL Vestibular Masterclass - Faculty member - presented on, lead on workshops and attended other lectures April 2026
· Vestibular Rehabilitation - A Competency Based Course 2025 - supported the faculty in completing delegate assessments and attended other lectures for own development
· Acute Vestibular Study Day - St Georges University 2025
· Multidisciplinary Management and Leadership Programme St Georges University Hospital NHS Foundation Trust 2024
· Vestibular Rehabilitation - A Competency Based Course UCL 2023
· ESMAC - Clinical Gait Analysis ESMAC - European Society For Movement Analysis in Adults and Children 5 days 2022
· The Neurorehabilitation of Walking UCL Partners Centre for Neurorehabilitation
· Advanced Clinical Educators Update Course St Georges University Hospital NHS Foundation Trust
· Basic Bobath Course BBTA 3 Weeks 2023
· The Neurorehabilitation of walking – 2022
· Analysis and Management of Paediatric Gait Allard UK 2021
· BBTA Introduction to the Bobath Concept Modules 1,2,3 BBTA 2019
· Advanced Management of Acute Spinal Cord Injuries St Georges University Hospital NHS Foundation Trust 2019
· Splinting In Neurology St Georges University Hospital NHS Foundation Trust 2018
· Major Trauma Study Day SGH 2018
· Advanced Spinal Cord Injury Study Day SGH 2018
Publications
- ‘Psychologically Informed Vestibular Physiotherapy Using the INVEST approach for Persistent Postural Perceptual Dizziness: A Case Report. Elizabeth Wood, PT, PGCert, Rachael Joyce, PT’ August 2025 Topics in Vestibular Physiotherapy, APTA & Academy of Neurologic Physical Therapy
Timeline
Principal Physiotherapist - Neuro & Vestibular Outpatient Department
St George’s University Hospitals NHS Foundation Trust
08.2025 - Current
Highly Specialised Rotational Neurological Physiotherapist
St George’s University Hospitals NHS Foundation Trust
05.2023 - 08.2025
Clinical Specialist Physiotherapist – Gait Laboratory
St George’s University Hospitals NHS Foundation Trust
06.2022 - 05.2023
Specialised Rotational Neurological Physiotherapist
St George’s University Hospitals NHS Foundation Trust
01.2018 - 06.2022
Band 6 Rotational Physiotherapist
Kings College Hospital NHS Foundation Trust
08.2016 - 01.2018
Band 5 Rotational Physiotherapist
North Cumbria University Hospital NHS Trust
06.2015 - 07.2016
Band 5 Bank Rotational Physiotherapist
Cumbria Partnership NHS Foundation Trust Bank
05.2015 - 06.2015
MSc (Pre-Reg) - Physiotherapy
Northumbria University
Bachelor of Science - Sports and Exercise Science
Leeds Metropolitan University