Delivering the right care in the right place is crucial for the long term recovery of stroke patients. Kate Hellier, Consultant Stroke Physician with the One Gloucestershire Integrated Care System (ICS), explains how the county is leading the way in specialist stroke care.
The consequences of a stroke can last a lifetime, but by delivering specialist stroke care quickly and supporting patients to maximise their recovery, we can try to minimise the effects and help people regain their independence.
Our approach to stroke care, based on national evidence, is focused on providing the right care in the right place for patients when they need it. To this end, staff from healthcare organisations are working together as one team to care for patients, whether at the acute hospital, at our new specialist community rehabilitation centre or in people’s homes.
Here in Gloucestershire, anyone suspected of having a stroke is assessed and treated in our dedicated stroke unit at Gloucestershire Royal Hospital. When a possible stroke patient comes to hospital, our stroke specialist nurses or advanced clinical practitioners go to the emergency department to make sure we deliver the best care in the first four hours.
We’ve worked with South Western Ambulance Service to raise awareness and recognition of the signs of stroke to get people into hospital quickly as this is crucial to giving people the best possible chance of recovery.
Giving treatments such as clot busting thrombolysis within four hours can make a huge difference to the damage caused for some people.
Some people who have had smaller strokes or good results from their initial treatment can go straight home. However, most people are transferred to the hospital’s specialist stroke unit, which offers both medical care and rehabilitation support. This includes physiotherapy, occupational therapy and speech and language therapy for speaking and swallowing, with additional support from dietitians and psychologists. Some patients may be able to go directly home within the first few days to weeks with support from the community team.
We also now have an excellent new specialist community stroke rehabilitation unit, which opened at Vale Community Hospital in Dursley in early 2019. This centre of excellence provides therapy to patients who no longer need more intensive medical care at Gloucestershire Royal Hospital, but who still need hospital-based rehabilitation.
The unit has weekly visits from a specialist stroke consultant and rehabilitation support is available Monday – Friday from a range of therapists, including physiotherapists, occupational therapists, speech and language therapists, therapy support staff, dietitians and psychologists. Continued by rehabilitation assistants and nursing staff at weekends, this support gives patients the time and space to recover and prepare for a safe return home.
Healthcare professionals there set goals together with their patients and check on their progress regularly. The team at the unit meets each week to discuss patients’ recoveries and they have individual meetings with patients and their carers to discuss their plans for getting back home.
Patients enjoy using social areas at mealtimes, and there’s also a therapy room and a kitchen where they can be assessed for coping with moving back home. The unit receives support from volunteer groups including the League of Friends and the Reconnect befriending service. There is an art group run by a local artist and a raised-bed area in the grounds for our gardening group.
So far, this specialist rehabilitation centre has received excellent feedback from both patients and staff and we’re hoping that in the future we’ll support around 150 patients each year.
We also help people to achieve as much independence as possible by continuing rehabilitation in their own homes through support from our Early Supported Discharge Team, which is made up of stroke-skilled rehabilitation specialists such as NHS therapists, therapy support staff and nurses.
We are immensely proud of how far we have come, and how we’re working together to give our patients the very best care.