Social care for stroke survivors: special report

Many stroke survivors and their carers are not getting the social care that can aid recovery, a report published last week by the Commons public accounts committee has found.

Stroke is the main cause of disability in England but stroke services are not given sufficient priority, say MPs.

Hundreds of stroke patients “needlessly die or suffer more serious disablement than they should,” according to the report.

MPs on the committee say community services for stroke patients after leaving hospital must be improved and made easier to access.

Stroke survivors need many different social care and health services and when “these are not provided in a joined up manner, patients can feel abandoned on leaving hospital,” it says.

It is true that stroke survivors can fall into a “black hole” following discharge from hospital with tricky transitions from health to social care services, agrees Joe Korner, director of communications at the Stroke Association.

His charity has 70 family support advisers, who help patients access assistance and manage the move from hospital to home. This service has proved extremely useful and the Stroke Association would be interested in extending it, if funds allowed.

Accessing services is imperative because stroke survivors can make a good recovery – but the social care and health services need to be in place to provide high-quality rehabilitation, says Korner.

Recovery can be hindered if needs are not met, he adds.

Around half of stroke patients receive rehabilitation services that meet their needs in the six months after leaving hospital. This falls to 25 per cent one year post hospital discharge, the Commons report finds.

Around half of people caring for stroke survivors have not received a needs assessment, it states.

Carers need more information to claim the services they are entitled to, argues the report. It points out that improved information for carers was promised in the health and social care white paper, published in January 2006.

The needs of stroke survivors living alone who may be “particularly vulnerable to being overlooked by health and social care services,” should be addressed, says the Commons report.

The government is committed to improving stroke services and development of a new strategy began in March 2006.

Areas being investigated include long-term social care support  provided after patients leave hospital.

There is currently no National Service Framework or white paper on stroke.

Concerns raised by the public accounts committee and the Stroke Association are not new.

Earlier this year a Healthcare Commission survey found that stroke patients are significantly less satisfied with the services they receive in the community than hospital care.

One third of patients rated their care as fair, poor or very poor, one year or more after leaving hospital.

More than a quarter said they needed low-level social care, such as help with cleaning and shopping, but more than half of these had received none.