Quality standard

Quality statement 3: Access to a clinical psychologist

Quality statement

Adults who have had a stroke have access to a clinical psychologist or a clinical neuropsychologist with expertise in stroke rehabilitation who is part of the core multidisciplinary stroke rehabilitation team. [new 2016]

Rationale

Many adults who have had a stroke experience psychological difficulties, including low mood and anxiety, as well as difficulties with cognition such as problems with memory and information processing. Psychological therapies may help people and their families or carers with these difficulties. Having a clinical psychologist or a clinical neuropsychologist as part of the core multidisciplinary stroke rehabilitation team can help to ensure that people have access to psychological therapy tailored to their needs.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements and protocols to ensure that services providing stroke care have a core multidisciplinary stroke rehabilitation team that includes a clinical psychologist or a clinical neuropsychologist with expertise in stroke rehabilitation.

Data source: Data can be collected from information recorded locally by healthcare provider organisations, for example, from service protocols. The Sentinel Stroke National Audit Programme (SSNAP) organisational audit collects information on the number of clinical psychologists for stroke unit beds.

Outcome

Quality of life for adults who have had a stroke.

Data source: Data can be collected from information collected locally by healthcare professionals and provider organisations, for example, from patient surveys.

What the quality statement means for different audiences

Service providers (such as secondary care providers) ensure that the core multidisciplinary stroke rehabilitation team includes a clinical psychologist or a clinical neuropsychologist with expertise in stroke rehabilitation.

Health and social care practitioners are aware of the need for a clinical psychologist or a clinical neuropsychologist with expertise in stroke rehabilitation to be part of the core multidisciplinary stroke rehabilitation team.

Commissioners ensure that they commission services that have a clinical psychologist or a clinical neuropsychologist with expertise in stroke rehabilitation as part of their core multidisciplinary stroke rehabilitation team.

Adults who have had a stroke who need help with psychological problems can see a clinical psychologist or a clinical neuropsychologist who specialises in stroke rehabilitation. The psychologist is part of the stroke rehabilitation team.

Source guidance

Stroke rehabilitation in adults. NICE guideline NG236 (2023), recommendation 1.1.3

Definitions of terms used in this quality statement

The core multidisciplinary stroke team

The team should comprise the following professionals with expertise in stroke rehabilitation:

  • consultant physicians specialising in stroke, or rehabilitation medicine

  • nurses

  • physiotherapists

  • occupational therapists

  • speech and language therapists

  • dietitians

  • clinical psychologists or clinical neuropsychologists

  • orthoptists

  • rehabilitation assistants

  • social workers.

[NICE's guideline on stroke rehabilitation in adults, recommendation 1.1.3]