Ruby Flanagan, aged 25, experienced a life-changing road traffic accident. At the time, Ruby was a dedicated nurse working on the colorectal ward, with four years of professional experience, and a mother to her six-month-old son, Leon.  

Ruby, who lives in Wallasey with Leon, began her rehabilitation journey in May 2022. We visited her again in September 2024 to check on her progress. 

Road traffic accident resulting in an amputation and fractures to the left leg and pelvis 

Ruby was crossing the road at the local retail park with her son, Leon, in a trolley when she was struck by a car. She managed to push Leon to safety before becoming trapped between two vehicles. 

Immediately after the accident, Ruby was airlifted to the Major Trauma Centre at Aintree Hospital, where she underwent emergency surgery to amputate her right leg and reconstruct her pelvis and left leg. 

During her stay at Aintree Ruby received support from the Day One Trauma Charity, who put her in touch with Irwin Mitchell Solicitors to manage her claim, and introduced her to her Case Manager, Lauren McCluskey, Specialist Case Manager and Occupational Therapist. 

Despite the intensive nature of her treatment at the Major Trauma Centre, Ruby was allowed daily visits from Leon, who was then taken home each night. She found being away from Leon during this time particularly difficult and missed crucial milestones in Leon’s early development, such as the weaning stage and his learning to crawl.  

Amputee Rehabilitation at STEPS Rehabilitation 

Ruby instructed Lauren McCluskey, to help establish and coordinate a pathway for therapeutic and care services. With her expertise as a specialist case manager in orthopaedic trauma and amputation, Lauren highly recommended STEPS Rehabilitation.  

“As a young mum myself, I was really emotional when I first met Ruby. She had experienced such a traumatic injury and also had a 6-month-old baby, who needed to stay with her.”

Lauren recognised the importance of getting Ruby into an amputee rehabilitation programme as quickly as possible once she was medically stable enough to leave the hospital. A key feature of STEPS Rehabilitation is its early post-op admission due to their expert wound and pain management following hospital discharge, overseen by Consultant in Rehabilitation Medicine, Dr Rohit Bhide. STEPS also has a specialist nursing team, experienced in providing expert amputee care, including advanced wound and scar management.  

“As a rehabilitation case manager, I advocate for early access to rehabilitation, as it significantly improves long-term outcomes for clients. According to the British Society of Rehabilitation Medicine (BSRM), early residential rehabilitation is highly recommended to optimise recovery. In alignment with this, NICE Guidelines emphasise that intensive rehabilitation provided in a residential setting offers better outcomes for clients, facilitating their recovery and overall well-being. Both sources highlight the importance of timely, structured, and comprehensive rehabilitation to maximise benefits for clients.” – Lauren McCluskey 

Ruby’s rehabilitation journey started with an online consultation, including a Zoom meeting with Toria, the Clinical Director, and the physiotherapy team. This initial meeting reassured Ruby that STEPS Rehabilitation could offer the comprehensive amputee rehabilitation she needed while also accommodating her son. 

Confident in the support offered, Ruby and Leon arrived at STEPS Rehabilitation and moved into the independent living apartment. At that time, she was dependent on a wheelchair for mobility.

“It was only once I got to STEPS Rehabilitation that I got my mum duties back. He needed me and I needed him.” – Ruby 

Ruby’s daily amputee rehabilitation programme was intensive and included: 

  • Physiotherapy: Regular sessions to rebuild strength, balance and mobility. 
  • Prosthetics: Fitting and adjustment to help Ruby adapt to her new limb. 
  • Amputee Physiotherapy: Specialist physiotherapy focussed on Ruby’s specific needs.
  • Physiotherapy Assistant: Massage therapy to alleviate discomfort and aid recovery. 
  • Art Psychotherapy: A recognised and effective mental health treatment. 
  • Clinical Psychology: provided by STEPS Neuropsychologist to support the psychological impact of her traumatic injuries. 
  • Solution Focussed Hypnotherapy: The therapeutic use of hypnosis was to help with pain and trauma.
  • Acupuncture: to aid pain relief and support overall recovery. 
  • Hydrotherapy: with an aquatic physiotherapist to enable movements and exercise within water of 35 °C, some of Ruby’s sessions included Leon in the pool with her.
  • Rehab Technology: Ruby had sessions in the MindPod and RehabHub for balance, core strength work and coordination. 

Recognising the benefits of having Leon present during her therapy, the physiotherapists and occupational therapists at STEPS Rehabilitation frequently included him in Ruby’s therapy sessions. This allowed Leon to join his mother in the pool for some of her aquatic therapy sessions and bath time and mealtimes for Leon were incorporated into Ruby’s therapy as these were some of her key goals.  . After a full day of therapy, which finished by 5pm, Ruby had time to feed Leon his evening meal, give him a bath, and put him to bed.

"Staying in the apartment at STEPS was invaluable to me as a mum, especially after feeling like I had missed so much of Leon's weaning stage. The apartment’s lounge and kitchen meant I could prepare meals for him myself, and we were able to share mealtimes together, which made a huge difference." - Ruby 

Progress and Independence 

Ruby’s background as a nurse played a crucial role in setting realistic recovery goals, especially as she became aware of the opportunities and benefits offered by STEPS Rehabilitation. Her experience on hospital wards made her realise that if she had been in an NHS rehabilitation ward, she would have faced limitations, such as only 20 minutes of physiotherapy and the added challenge of being separated from her son. 

By early 2022, Ruby had made remarkable progress. Initially confined to a wheelchair, she advanced to walking with two walking sticks. Her increased strength enabled her to perform more independent tasks, such as bathing Leon, putting him to bed, and preparing his meals. One of her key goals was to walk independently up and down stairs with Leon. 

“STEPS Rehabilitation is a case manager's dream, there are regular multidisciplinary team (MDT) meetings, continuous updates on clients' progress and goals, and details of the activities they engage in to achieve those goals. Frequent meetings with solicitors and defendant insurers, who were funding her stay, also ensured effective communication throughout. Upon discharge, a dedicated discharge meeting was held to ensure that the progress she made at STEPS would be maintained when she returned home.” – Lauren McCluskey 

Ruby's long-term aspirations include returning to the nursing profession, possibly in a less demanding role within trauma support. She also plans to resume her driving test, which was interrupted by the accident, and to continue her rehabilitation with ongoing support from STEPS Prosthetics. 

Prosthetic Provision and Return Home 

The integration of prosthetic care within STEPS Rehabilitation was key to Ruby’s success. Working closely with her physiotherapists and prosthetists, Ruby’s rehabilitation focused on improving her gait, balance, and overall confidence with her prosthetic limb. The interdisciplinary approach ensured that every aspect of her rehabilitation journey, from fitting to functional training, was carefully coordinated to meet her needs as an amputee and a mother.

One of Ruby’s primary goals was to regain her independence with Leon, and the provision of a waterproof prosthetic leg became essential. Living on the coast and being an active mother meant that Ruby needed a leg that would allow her to take Leon swimming, visit the beach, and engage in water-based activities. STEPS Prosthetics fitted Ruby with a waterproof prosthesis, transforming her ability to participate in daily life without limitations.

Ruby’s journey through prosthetic rehabilitation has been ongoing, with regular check-ups and adjustments to ensure her prosthetic leg continues to meet her needs. Most recently, she was fitted with a cosmetic prosthesis with a custom silicone covers, providing a realistic appearance to restore her body image, allowing her to wear skirts and dresses confidently without feeling the need to hide her prosthesis.

Returning Home 

Following the removal of the external fixator on her left leg and the metalwork from her pelvis, Ruby completed an additional eight weeks of rehabilitation before returning home.

Her current home is unsuitable for her to live in long-term, so a new property has been purchased and is being adapted for Ruby and Leon by Steven Docker Associates. The new home will be open-plan, with a through-floor lift, level access, and a therapy gym to allow Ruby to continue her rehabilitation in comfort. 

Ruby continues to return to STEPS for prosthetic adjustments and therapy and enjoys meeting with and supporting current clients by sharing her journey so far.  

In October 2024, she spoke at the STEPS Amputee Conference, inspiring others with her remarkable recovery. 

Today, she leads an active lifestyle, caring for Leon, holidaying with friends, and enjoying nights out.