1,000 Lives Plus project to concentrate on life after stroke

Dr Anne Freeman explains how a new 1,000 Lives Plus project will help people recover from stroke

WHEN a person suffers a stroke, the impact on their life can be devastating.

As well as the physical trauma, many stroke survivors are left feeling emotionally vulnerable and alone when they leave hospital and return home.

This is the time when having easily accessible and appropriate services and support available in the community is vital.

And yet, many stroke survivors tell us they often feel abandoned and in a “black hole”, unsure of who to turn to for help and information.

That’s why Life after Stroke – a new area of work from the 1,000 Lives Plus programme – is so important. 1,000 Lives Plus is the national improvement programme supporting organisations and individuals to deliver the highest quality and safest healthcare for the people of Wales.

Life after Stroke aims to better co-ordinate services across health, social care and voluntary sectors to improve the support available for stroke survivors.

But it will be shaped and guided by those who know best what’s needed – stroke survivors, their families and carers.

The work will start with a special event in March bringing together stroke survivors from across Wales to share their experiences.

We want to learn from these experiences and hear directly about what they feel would improve their care and quality of life.

We will use this information to help shape services for the future and agree priorities – whether this is in physiotherapy, speech therapy, dietary services, social services support or access to information and support groups.

Good progress has already been made by health boards – with the support of organisations including the Delivery and Support Unit, the Stroke Association in Wales and the Welsh Stroke Alliance.

There has been a real improvement in diagnosing and treating patients with acute stroke; providing clot-busting treatment known as thrombolysis; in the management of mini-strokes (transient ischaemic attacks or TIAs) and in early rehabilitation.

Now we need to work on what happens to the patient when they return home and help them to re-integrate into the community and maintain the best quality of life possible.

We know from talking to stroke survivors there’s life after stroke but they need help and support to make this happen and more importantly, you need to know how and where to access it.

Life after Stroke will provide a framework that will help to standardise care for stroke patients in the months following their discharge from hospital.

It recommends regular, comprehensive reviews after leaving hospital at six weeks, six months and annually.

They will be carried out by the most appropriate person, according to the patient’s needs, and could be the hospital, GP or support worker.

It will include a medical review, lifestyle advice, prescription update and referrals, if necessary, to services needed.

It will treat everyone as an individual and aims to ensure a more seamless transfer of care for stroke survivors.

It will also hope to pick up issues at an early stage and address them sooner, for example providing counselling to help emotional needs or practical support such as helping someone return to work.

It’s in this area 1,000 Lives Plus will be working closely with the Stroke Association, which already provides an excellent support service to stroke survivors, providing information and practical help in many areas, including benefits advice and support groups.

We know there’s much to be done but by working together across the sectors we hope to formulate the best ways forward to ensure stroke survivors have a better quality of life.

* Dr Anne Freeman is the clinical lead for stroke in Wales and a member of the 1,000 Lives Plus Faculty. She was appointed OBE in the New Year’s Honours for her contribution to stroke medicine and medical education in Wales