Life After Stroke Commissioning Guide

Mark Hindmarsh

Senior Project Officer,Commissioning Support for London

London stroke strategy – where this fits

London stroke strategy (2008)

Public consultation (2008/09)

Rehab commissioning guide (2009)

Life after stroke (2010)

Principles

Active citizenship

Quality of life

Empowerment

Scale of need

• Prevalence ranges from 1.6% to 0.8% of registered GP population• 88,000 people across London on GP registers have had a stroke or TIA

Sum of stroke and TIA patients in a GP register in 2008/9

Diverse needs

15% have on-going continence problems

25% of nursing home residents have had a stroke

33% of stroke survivors report depressive symptoms

20% “silent stroke” – underlying cognitive problems

Regular review

Needs change over time

Recognise variability of needs and aspirations

National guidance – 12 monthly review

Stroke survivor

Social care

GP

Therapist

Stroke navigator

Structured social group

Information

Stroke care navigator– Single point of contact– Direct role in delivering care– Coordinate care packages– Training stroke survivors and carers– Work across different sectors

London stroke directory

www.londonstrokedirectory.org.uk

Engaging with community life

Stroke survivors do not get out of the home as much as they would like

Building confidence

Addressing practical issues

Community/social groups have benefits beyond primary purpose

Peer support & peer-led services

Peer support

Improve emotional wellbeing

Build capacity

Sense of purpose

Range of functions

Confidence

Source of information

Improve functional

status

Carers and families

Carers have a right to their own needs review

Training and education should be provided

Local authority and charitable sector support is available

Conclusion

Operating services across the different sectors has track record of success

Develop and empower people

Published guide is available today

Will also be available to download

stroke@csl.nhs.uk