Year published: 2019
This briefing highlights the commitments in the Long Term Plan for stroke rehabilitation.
Key messages from the CSP and ACPIN on the stroke rehabilitation pathway
- Local rehabilitation systems needs to be considered as a whole, embedded from admission – adopting a symptoms and needs based approach to service and pathway design
- Stroke rehabilitation is similar to other neuro rehabilitation and should be brought together
- A neuro rehabilitation team needs to be embedded as part of this overall rehab system
- Treatment plans should direct patients to the most appropriate rehab support for them, delivered by multidisciplinary community rehab teams drawing on both clinical and non-clinical skills and utilising community assets as appropriate
- Ongoing rehabilitation in the community needs to be continuous, with no gaps
- Smooth and timely referral to rehabilitation services is essential, supported by Early Supported Discharge services
- Community rehab teams needs to have open access to neuro rehab teams to ensure hand over systems are working, for specialist advice, training and if necessary for referrals back in
- Self-management of neurological condition needs to be implemented from the start of the rehabilitation journey to empower individuals to aspire to live well and manage their own neurological condition
- Emphasis on partnerships with local authorities and third sector agencies supporting individuals to access appropriate exercise facilities is key
- Addressing the needs of those individuals with a life-limiting neurological condition by the inclusion of neuro-palliative care services and support is essential.
Implementation and further development of higher intensity care models for stroke rehabilitation are expected to show significant savings that can be reinvested in improved patient care.