Meeting the standards

Marisa Rose Acute Stroke Lead NEL Cardiac and stroke networkMarisa.rose@bdpct.nhs.uk

Sue Winnall Head Occupational therapist – Rehabilitation Mile End HospitalSue.winnall@thpct.nhs.uk

National stroke strategyLondon stroke strategyRCP guidelines

What is needed? Specialist rehabilitation (NS QM 10) Community stroke service with staff with

stroke specialist skills (LSS) ESD service with staff with stroke

specialist skills (LSS) Vocational rehabilitation (NS QM16) Long term support (NS Qm13 and 15)

Standards- Inpatient

Appropriate seating, posture and positioning within 24hrs of admission

Outcome measure given and recorded within in one week of admission and discharge

Named key worker within one week of admission

Negotiated goals within one week of admission with appropriately format copy given

5 x 45 mins face to face sessions per week of OT/PT/SLT as necessary

Standards- Inpatient

Cognitive/perceptual screening and full assessment within one week if required

Screening for emotional support as soon as possible

At least one family meeting with MDT before discharge and receiving copies of minutes and care plan during their admission

Discharged on clinically preferred day

Standards- communityContacted by a member of the community rehabilitation team within 24 hours and assessed within three days

Treatment programme started within 24 hours (ESD intensity level) or seven days (non-ESD) of assessment

Visited at home by community nursing team within 24 hours where agreed as part of care plan

Outcome measures recoded within one week of arrival to, and one week of discharge from, community rehabilitation service

Standards- community

A set of short term and long term goals negotiated with them, their family/carers and the rehabilitation team of which they receive a copy appropriately formatted for their individual needs within 2 weeks of admission to the community rehabilitation service

Receiving 3 hours 45 minutes per week (ESD) and/or two hours 15 minutes per week for the first four weeks (non-ESD/post ESD)- of individual sessions of OT/PT & SLT

Cognitive/perceptual screening within 1 week of admission and full ax within 12 weeks if required

Standards- comm and voluntaryPatients previously in work receiving vocational rehabilitation

Patients and family who the community rehab team idenitify as having a need for further ax or intervention to meet adjustment, behavioural or psychological needs and who were seen within 2 weeks of referral to the team

Locations with commissioned activity where a comprehensive set of standards and information about services is available

Outcomes recorded for patients who have accessed voluntary services as part of stroke care

What does this mean?

Who its provided byWhat’s providedHow it is provided

Intensity SpecialismDuration

How much to buy? What are the benefits?

London stroke strategy standards Inpatient – 5 x 45 mins of OT, PT , SLT per

week as necessary (R15) ESD- 3 hours 45 mins per week within the

first two weeks Community- 2 hours 15 mins per week for the

first four weeks of individual sessions OT, PT and SLT

Specialism

How much is enough?Your choice … what outcome do you

want?

What is provided?

MDT Specialist

What is the difference …

Intermediate care teamsNeurology teams Case managementOutpatient clinics ESD vs community team

In Summary

Standards provide basic requirements

Type and purpose of the service will guide measures used

Stroke rehabilitation is worth the investment!