‘Patchy’ rehab for stroke and major trauma

Provision of rehabilitation services for both stroke and major trauma patients is variable, and improvements in follow-up stroke care have not matched those in the acute sector, according to the National Audit Office.

However, the NAO says measures such as the national stroke strategy, launched in 2007, and a 2009 campaign to raise awareness of the condition were starting to deliver and to improve patient outcomes. The wider provision of specialist stroke units meant patients had a better chance of surviving, with fewer complications, and regaining their independence. However, many patients still did not reach stroke units or receive a scan quickly enough, according to one of two new NAO reports. The organisation says community-based stroke specialist rehabilitation teams, such as early supported discharge, can be more effective than hospital-based care for stroke patients with moderate disabilities. But only 36 per cent of hospitals had such teams and there was confusion about funding. The NAO recommends community-based stroke-specialist rehabilitation is made available for all appropriate patients. Nikki Hill, spokesperson for The Stroke Association said post-hospital support was essential ‘so that stroke survivors get the care and support they need, irrespective of where they live’. In a separate report the NAO estimates that up to 600 lives could be saved if major trauma care in England was managed more effectively to address ‘unacceptable’ variation. It also found that rehabilitation services for patients suffering major trauma were patchy across the country and lacked coordination. Reviews of major trauma services had often overlooked rehabilitation, and there was little hard evidence on which services were available and how well they were organised to meet patient needs. Highlighting a lack of capacity, the report said: ‘This leads to patients with complex injuries remaining unnecessarily on general acute wards, and being cared for by staff without the specialist skills required to manage them appropriately.’ Report author Mark Davies called for more information on what rehabilitation provision was available, whether it matched patients’ needs, and how well it performed.

Further information

Read the reports at www.csp.org.uk/news    
Matthew Limb

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