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Changes to stroke rehabilitation services

We consulted patients about our plans to make stroke rehabilitation services more joined up with each other and focused on what individual people need, regardless of where people live. We ran a consultation between January - April 2016, holding a series of public drop in sessions and attending a range of community meetings. Three hundred and thirty responses to the consultation were received: 320 questionnaires and 10 letters/emails.

There was strong support for the preferred option: home-based services where possible and one stroke rehabilitation unit on the King George Hospital site. There was also strong support for establishing new home based services. The decision was made to implement the agreed changes.

Follow this link to read the report on the consultation.

The proposals were discussed at the July 2016 Governing Body meeting (item 5.2)  and approved by the governing body, subject to development of a robust implementation plan. 

About the stroke rehabilitation consultation  

We wanted to make stroke rehabilitation services more joined up with each other and focused on what individual people need, regardless of where people live. We believed doing this would mean people receive specialist care, tailored to their needs, which would help them to recover better and more quickly.

Read the consultation document or easy read consultation document.

Summary of the changes proposed

Current arrangementsChange being proposed
Early supported discharge (ESD, a type of rehabilitation at home) is offered by two providers with a handover from one to the other partway through treatment A streamlined ESD service delivered through one provider that will improve continuity of care.
Residents in the west of Redbridge can’t have ESD. The ESD service will be extended to cover the whole of Redbridge.
Not all of the features of a high quality ESD service are available across the three boroughs. Patients eligible for ESD who also require speech and language therapy either have to remain in hospital or receive therapy in the community long after their ESD has finished. Stroke patients will receive care from a high quality stroke specialist multidisciplinary team, and will have equal access to speech and language therapy and psychology; enhancing what is already available in the community.
Many patients don’t get ESD for six weeks which is the standard recommended by NICE. All patients will receive up to six weeks ESD based on need.
Currently the criteria applied to access inpatient care are not consistent. All patients will access the inpatient service through a single set of access criteria and the quality of inpatient care provided will be standardised.
Numbers of patients receiving ESD fall well below 40%. We estimate around 25% of patients who are eligible for ESD are not accessing it. Up to 40% of patients surviving stroke are likely to be eligible for ESD. Evidence states that "Patients who receive Early Supported Discharge services will return home earlier and are more likely to remain in the home long term and regain independence in daily activities".
ESD is provided by two providers (BHRUT and NELFT).  Community stroke rehabilitation is provided by NELFT but as three separate teams. There will be common service providers working to a shared set of standards across all of BHR; community neuro-rehabilitation and ESD will be provided by the same provider as one service.
Stroke rehabilitation inpatient beds at Grays Court in Barking and Dagenham and King George Hospital in Redbridge. There will be one provider of stroke rehabilitation inpatient services on one site, at King George Hospital.


Further information

Case for change – gives an overview of current stroke rehabilitation services and explains how services could be improved.

Case for change highlights – shorter version of the case for change.

Initial equality impact assessment (EIA) – this sets out the impact the changes proposed in the consultation might have on different groups.  A final version will be published after the consultation closes and will take into account comments received during the consultation. The final EIA will go to the CCG governing body as part of the decision-making evidence. 

Pre-consultation business case – this details the progress made to improve and develop stroke rehabilitation services and provides evidence of the case for making changes to services.

Page last updated 08 October 2019