Agenda item

Stroke Rehabilitation Update

Indicative Timing – 10:05 to 10:45


Please note the Update provided at the Committee meeting on 10 July 2018:


The report will update the Committee in relation to the following points raised previously:

·         Accessibility of the site; were public transport options sufficient to enable patients to receive visitors?

·         How this change impacted on the rest of the service provided at the Vale Hospital.



4.1      Paul Roberts introduced the presentation reminding members of the discussion in July 2018. The decision had been made by the CCG and Trusts in August 2018 and was established at the Vale Community Hospital and the unit had opened in February 2019. There was encouraging progress to report on. Candace Plouffe explained that the changes were in response to a review of the county’s rehabilitation services which highlighted that a change was needed for the county to provide consistent and high quality rehabilitation to improve patient outcomes.


4.2      An engagement process was carried out with concerns identified around transport issues for visitors and insufficient beds in the locality for general needs. This was mitigated by sharing bed modelling process and outcome and reviewing and monitoring transport links. It was confirmed that there was ongoing provision for Musculo Skeletal physiotherapy at the Vale Community Hospital.


4.3      It was explained that at the Vale Community Hospital there was a high calibre team which had been able to begin a robust educational programme to develop specialist skills as well as forge strong links with the rest of the hospital. It was stated that the IT systems were also robust and the equipment was very good to help support the right group of patients.


4.4      The committee were provided with the expected benefits including a rehabilitation gym and social space for patients to come together. Therapy took place at any time within the unit seven days a week. Rooms were all single occupancies with en-suites. Previous issues had been regular access to enough therapy inputs per patient, the new unit had allowed an increase in this per patient, in particular extra speech and language therapy.


4.5      Members noted the statistics provided in the slides where it was reported that there had been 29 admissions since the opening in April 2019.  Bed occupancy was now at 97% and a 100% improvement in patients ‘Activity of Daily Living’ score as determined using the Barthel measurement tool.


4.6      Members noted the experiences provided from clinicians which was very positive, in particular outlining how existing staff at the Vale Hospital had welcomed them and that skills and expertise overlapped and were shared.


4.7      The Committee was provided with details of the patient experience which also included feedback on the wider team, from the acute experience at Gloucestershire Royal Hopsital through to Early Supported Discharge to home and the extended stroke rehabilitation at the Vale Community Hospital. The feedback from patients had been very positive with details provided of the impact and improvement in outcomes from the treatment.


4.8      With regards to next steps, a formal service review would be carried out in September 2019with an analysis of SSNAP outcomes and the continuation of the review and transformation of Stroke care pathway. The Chair commented how the presentation seemed to demonstrate that an enhanced service had been delivered.


4.9      In response to a question it was explained that there were conversations daily with patients and it was about having the right patients in the right place at the right time to deliver the best outcomes.


4.10    One member asked for clarification regarding the threshold for admission and the criteria being used, as well as querying the impact of the location with regards to transport issues. In response it was explained that if a patient had complex needs such as a feeding tube then it may not be suitable to move them to the Vale Community Hospital. Everyone else would be eligible and it was important to ensure there was a flow of patients through the Vale Community Hospital. With regards to transport, when patients understood the benefits on offer they were often willing to travel and there was good free parking facilities. Public Transport availability was being monitored and this would be picked up in the review.


Supporting documents: