Early Supported Discharge for Stroke
A vital priority within the NHS’s stroke improvement programme is to ensure 40% of
all stroke survivors are provided with specialist early supported discharge (ESD)
services from hospitals.
In practice there is variation around the UK on what defines an early supported
discharge team and the criteria for acceptance of a patient by stroke teams. Whilst
there is variable evidence of the effectiveness of ESD teams the challenge is to
interpret the evidence and more importantly successfully implement a complex
rehabilitation pathway, to enable a person after their stroke to receive specialist
rehabilitation earlier and within their own homes.
An Early Supported Discharge Team for stroke survivors currently operates for both
Sandwell and West Birmingham residents. Whilst the ESD team accept referrals
from across the country they have united directly with Sandwell acute stroke ward
and work as one team. Staffs regularly in-reach and out-reach into each service thus,
competencies and skills are developed and shared and the models of rehabilitation are
challenged. The team facilitates and takes ownership for discharge with local
community teams (I-cares and SPA) offering support for packages of care.
The ESD team provides home rehabilitation, a vital component of improving stroke
care, at the same intensity of inpatient care (where indicated). The ESD Team builds a
service that is bespoke to each individual, offering choice and involvement with their
care needs, circumstances and preferences. This offers an experience of a smooth and
coordinated return home from hospital and access to a broad range of services to help
them recover from, and cope with, the effects of stroke. Ultimately this in turn
improves service provision for transfer of care, delivers efficiency in acute bed usage
and delivers improved clinical and well being outcomes.
The ESD team consists of specially trained Physiotherapists, Occupational Therapists,
Speech Language Therapists, Dietetics and Nurses. The ESD team have direct access
to specialist clinics including orthotics, functional electrical stimulation (FES),
spasticity management, psychology, voluntary groups and the Stroke Association.
The stroke team (ESD and acute) continue to strive to deliver best evidenced based
practice under the right care, right here model of SWBH Trust.