AT the beginning of August the Trust launched an innovative new pilot service to help rehabilitate stroke patients in their own homes.
The Stroke Early Supported Discharge Service (ESD), jointly funded by the Trust and NHS Bournemouth and Poole, allows patients who have experienced a mild to moderate stroke leave hospital earlier and have their stroke specialist rehabilitation at home.
The service is made up of staff members from a variety of disciplines such as stroke specialist physiotherapy, occupational therapy, nursing, speech and language therapy and rehabilitation assistants.
They are on hand seven days a week and are supported by a Stroke Consultant.
Patients receive stroke specialist rehabilitation at home from a multi-disciplinary team for around two weeks after they leave hospital.
After that, they are referred to appropriate community services for on-going support and rehabilitation if they need this.
This will benefit patients from:
• A smooth and seamless transfer from hospital to home - patients are seen at home within 24 hours of discharge from hospital.
• Rehabilitation centred around patients’ goals and delivered in a setting meaningful to their lives.
• More independence and a reduction in long-term dependency.
• Improved outcomes - evidence indicates that patients benefit physically and psychologically as a result of being cared for at home.
Claire Stalley, ESD Lead, said: “Research evidence and national clinical guidance shows that patients with mild to moderate stroke can recover quicker when receiving their specialist rehabilitation at home delivered in new, innovative ways. This person-centred approach ensures patients and carers are involved in all stages of discharge planning, are enabled to leave hospital sooner than they would have previously while being fully supported by a specialist team on returning home.”
The new model of care impacts across the whole health economy as it involves and collaborates with the whole health and social care community across the RBCH catchment area.
This new approach to patient care will challenge historic practice and benefit all involved.
This service, a six-month pilot, has been developed using research evidence and national clinical guidance.
For the course of the pilot the team will monitor the impact of the service on patients, carers, the inpatient stroke service and the wider health and social care community.
Dr Mary Armitage, Medical Director
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