Stroke survivors face postcode lottery in community care

Stroke survivors face a postcode lottery in aftercare with big inconsistencies in access to rehabilitation between areas, the Care Quality Commission said today.

In a review of stroke care, the Care Quality Commission (CQC) said that although there were some good services, particularly in the North East and South West, they were far from universal.

Key findings included that:-

• Only two-thirds of primary care trusts commissioned specialist stroke physiotherapy.

• Less than 40% of areas provided good access to psychological therapy or stroke counsellors.

• Early supported discharge, which provides more rehabilitation at home rather than in hospital, was available across just 37% of areas, despite evidence that it achieves better results for people.

The findings come three years into the national stroke strategy which set out a 10-year plan for the development of stroke services in England, including the care and support needed after stroke.

The CQC listed 13 areas for improvement, and called on the Department of Health to ensure support was in place to complete the implementation of the national stroke strategy.

The findings mirror a report last year by the National Audit Office, which found the quality of aftercare for stroke survivors had not matched improvements in hospital care for the group.

CQC chief executive Cynthia Bower acknowledged improvements had been made, but the level of variation was a concern.

She added: “We expect to see local health and social services working with stroke survivors, carers and representative groups to agree and implement a plan to improve services drawing on the results of our assessments of services in local areas.”

This point was echoed by the NHS Confederation. Deputy director of policy Jo Webber said: “Meeting the needs of individuals and their carers will require greater co-ordination and investment between local health and social services.” She suggested that some of the £1bn a year allocated to the NHS to spend on social care over the next four years could be used to support stroke survivors.

However Joe Korner, communications director at the Stroke Association, warned that several community based services were under threat of closure as a result of budget cuts.

He said: “We are at risk in some areas of the standard of post-stroke care regressing to that of before the national stroke strategy was launched. This comes at a time when evidence suggests more not less investment is needed to help stroke survivors in the community with their recovery.

“We therefore urge all commissioners to incorporate the findings of this report into their future plans”.

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