This weeks #OTalk is on the topic of “Challenges of maintaining stroke specialist services in the current commissioning environment” and will be hosted by the RCOT Specialist Section Neurological Practice- Stroke forum (@OTstrokeSSNP).
Here is what they had to say…
We are all aware of the current financial pressures facing the NHS. Many of you may also be aware of the recent work for NHS England to create Sustainability and Transformation Partnerships (STPs) and more recently Accountable Care Systems (ACSs), seeking to bring about system change and integration between organisations and across agencies in answer to the Five Year Forward View.
As a stroke forum we have been contacted by members concerned that stroke specialist services might be at risk during this process, with a move in some areas to have more generic community services, capable of managing all conditions, in the hope of maximising economies of scale and gaining maximum efficiency from resources.
In stroke we are lucky to have a good evidence base regarding Early Supported Discharge (ESD) and have clear recommendations through the current stroke strategy, RCP and NICE guidelines that stroke care requires stroke specialist and stroke skilled staff along the pathway.
However some questions remain less clear:
- At what point does the stroke specialist requirement taper off?
- How do stroke specialist teams and community specialists teams best interface to meet the needs of stroke patients, many of whom have multiple comorbidities and may be well known to general community rehabilitation teams prior to their stroke?
- In more rural areas or where stroke numbers are low, how do you best arrange services to maintain a good level of stroke specialist skills and be maximally effective?
In this time of significant change within the NHS and social care, it is clear that pragmatism is required, whilst still seeking to adhere as close to the evidence as possible, to provide best outcomes for stroke patients. (NB- the same discussion is relevant for those with other neurological conditions).
The objectives of the session are to:
- Discuss and debate the challenges
- Identify the key levers and evidence to maintain specialist services
- Consider how best to demonstrate the impact of your services
- Discuss ways of maintaining stroke skills in non-stroke specialist community rehab teams.
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