Being Chief Operating Officer at Cognivate, a community-based neurorehabilitation team, means I sit behind the scenes of client care. Rather than focusing on delivering therapy, it’s about ensuring the right people, resources, and systems are in place to make rehabilitation possible. My work spans quotes, invoicing, therapist capacity, marketing, financial oversight, and strategy planning. At the same time, I’m working with our CEO and Clinical Director to build a culture that therapists want to be a part of, because a strong and motivated team is ultimately what benefits clients most.
Every new enquiry we receive starts with a puzzle. Geography matters first: a therapist who lives an hour closer can save a client hundreds of pounds over a block of sessions, and, crucially, keep energy for therapy rather than travel. But proximity is only the beginning. We then map needs to expertise: vocational rehabilitation for a return-to-work plan; support for cognitive-communication disorder (CCD) to rebuild attention, memory and executive skills; EMDR to process trauma; or vestibular therapy to steady the world when dizziness derails daily life. A great match is rarely confined to one discipline; it’s an interdisciplinary blend that makes sense both clinically and practically.
The reality is that these matches happen while ten other things are moving. Referrals arrive at different levels of urgency, diaries shift, and daily pressures create constant change. Our therapists, neuropsychologists, occupational therapists, physiotherapists and speech and language therapists each have their own caseloads, travel tolerance and special interests. Coordinating all of this means constantly balancing priorities, spotting gaps before they appear, and making sure nothing falls through the cracks.
To navigate that complexity, we build in three habits.
First, we focus on clarity and efficiency. We gather just enough information to understand the client’s needs, identify the right mix of therapists, and issue a clear quote without delay. The aim is to balance accuracy with respect for case managers’ time, ensuring we have what we need to match the right team, without overloading anyone with unnecessary questions at this early stage.
Second, matching by strengths, not titles. A therapist’s postcode matters, but their passions matter more. One OT might thrive on complex fatigue management; another brings deep experience in sensory regulation or return-to-driving assessments. A neuropsychologist with EMDR training can unlock progress where avoidance or trauma has stalled other work. Our vestibular-trained physios often become the hinge for clients who can’t tolerate screens or busy supermarkets; progress there makes everything else possible. The best match reduces friction and builds momentum.
Third, we stay transparent. We explain therapist availability openly, who is best placed to support the client and what the practical considerations are. When more than one clinician is suitable, we can present each option clearly so case managers can choose the best fit. This openness supports smoother planning and stronger partnerships
And none of this is achieved single-handedly. Our operations team keeps the system steady by coordinating diaries, preparing quotes and invoices, monitoring report deadlines, onboarding associates, and organising the appointments, goal reviews and MDT meetings that quietly hold the process together. Their quiet reliability gives clinicians the headspace to focus on therapy, and gives me the visibility to plan capacity, manage risk and invest in growth.
So what does a typical week look like for me as COO? It’s not about the intricacies of rehabilitation goals. It’s about keeping the whole system moving. I’m sending quotes and invoices to ensure clients and case managers have clarity on costs. I’m monitoring therapist capacity so we don’t overburden anyone and can spot when and where we need to recruit. Marketing is always on the horizon, making sure people know we exist and that our interdisciplinary model brings something different. I spend time with spreadsheets and forecasts, tracking finances so we can grow sustainably while keeping services competitive. Strategy planning is constant: where next, who next, and how to build in resilience. And underpinning it all is culture, working to create a positive environment where talented therapists want to be, and where collaboration feels natural, not forced.
Being a COO in community neurorehab might not be glamorous. It’s granular. It’s quotes, invoices, strategy meetings and marketing campaigns, threaded together with human stories and specialist skills. Every client is a puzzle, and my responsibility and privilege is to pull together the best team so the picture makes sense again.