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Stroke rehabilitation in adults [CG162]

Measuring the use of this guidance

Recommendation: 1.1.3

A core multidisciplinary stroke rehabilitation team should comprise the following professionals with expertise in stroke rehabilitation: - consultant physicians - nurses - physiotherapists - occupational therapists - speech and language therapists - clinical psychologists - rehabilitation assistants - social workers.

What was measured: The proportion of days in hospital on which psychology is received for patients who require it.
Data collection end: March 2015
8%
Data collection end: March 2016
9.1%
Data collection end: March 2017
10.2%
Data collection end: March 2018
10.4%
Data collection end: March 2019
10%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.


Recommendation: 1.1.8

Offer early supported discharge to people with stroke who are able to transfer from bed to chair independently or with assistance, as long as a safe and secure environment can be provided.

What was measured: Proportion of patients treated by a stroke skilled Early Supported Discharge team.
Data collection end: March 2014
24.7%
Data collection end: March 2017
34.6%
Data collection end: March 2018
35.5%
Data collection end: March 2019
39%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

What was measured: Proportion of acute trusts that cover stroke within their early supported discharge scheme.
Data collection end: October 2015
95%
Area covered: England
Source: NHS Benchmarking Network. Older People’s Care in Acute Settings Benchmarking Report.


Recommendation: 1.1.10

Hospitals should have systems in place to ensure that: - people after stroke and their families and carers (as appropriate) are involved in planning for transfer of care, and carers receive training in care (for example, in moving and handling and helping with dressing) - people after stroke and their families and carers feel adequately informed, prepared and supported - GPs and other appropriate people are informed before transfer of care - an agreed health and social care plan is in place, and the person knows whom to contact if difficulties arise - appropriate equipment (including specialist seating and a wheelchair if needed) is in place at the person's residence, regardless of setting.

What was measured: Proportion of patients who are given a named person to contact after discharge.
Data collection end: March 2015
85.8%
Data collection end: March 2016
90.9%
Data collection end: March 2017
95.5%
Data collection end: March 2018
96.7%
Data collection end: March 2019
96.6%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.


Recommendation: 1.1.11

Before transfer from hospital to home or to a care setting, discuss and agree a health and social care plan with the person with stroke and their family or carer (as appropriate), and provide this to all relevant health and social care providers.

What was measured: Proportion of applicable patients receiving a joint health and social care plan on discharge.
Data collection end: March 2015
81.2%
Data collection end: March 2016
87.8%
Data collection end: March 2017
90.3%
Data collection end: March 2018
93.1%
Data collection end: March 2019
94.2%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.


Recommendation: 1.2.12

Review people's goals at regular intervals during their stroke rehabilitation.

What was measured: Proportion of applicable patients who have rehabilitation goals agreed within 5 days of clock start.
Data collection end: March 2017
92.5%
Data collection end: March 2018
92.3%
Data collection end: March 2019
93.2%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.


Recommendation: 1.2.16

Offer initially at least 45 minutes of each relevant stroke rehabilitation therapy for a minimum of 5 days per week to people who have the ability to participate, and where functional goals can be achieved. If more rehabilitation is needed at a later stage, tailor the intensity to the person's needs at that time.

What was measured: Compliance (%) against the therapy target of an average of 25.7 minutes of occupational therapy across all patients (Target = 45 minutes x (5/7) x 0.8 which is 45 minutes of occupational therapy x 5 out of 7 days per week x 80% of patients).
Data collection end: March 2014
55.5%
Data collection end: March 2016
79.4%
Data collection end: March 2017
83.1%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

What was measured: Compliance (%) against the therapy target of an average of 27.1 minutes of physiotherapy across all patients (Target = 45 minutes x (5/7) x 0.85 which is 45 minutes of physiotherapy x 5 out of 7 days per week x 85% of patients).
Data collection end: March 2014
53%
Data collection end: March 2016
73.3%
Data collection end: March 2017
78.2%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

What was measured: Compliance (%) against the therapy target of an average of 16.1 minutes of speech and language therapy across all patients (Target = 45 minutes x (5/7) x 0.5 which is 45 minutes of speech and language therapy x 5 out of 7 days per week x 50% of patients).
Data collection end: March 2014
24.1%
Data collection end: March 2016
41.5%
Data collection end: March 2017
46.8%
Data collection end: March 2018
50.8%
Data collection end: March 2019
52.1%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.


Recommendation: 1.11.5

Review the health and social care needs of people after stroke and the needs of their carers at 6 months and annually thereafter. These reviews should cover participation and community roles to ensure that people's goals are addressed.

What was measured: The proportion of applicable stroke patients who had a six month follow-up completed.
Data collection end: March 2016
29.9%
Number that met the criteria: 17402 / 58246
Data collection end: March 2017
32.2%
Data collection end: March 2018
32.4%
Data collection end: March 2019
31.6%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.

What was measured: Proportion of patients who receive a six month assessment.
Data collection end: March 2014
16.5%
Area covered: Great Britain
Source: Royal College of Physicians. Sentinel Stroke National Audit Programme.



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