OUH initiative gets stroke patients home sooner
Date: 08 July 2019
A highly specialist service provided by Oxford University Hospitals that has helped thousands of stroke patients recover in their own homes is celebrating the first anniversary of its launch following a successful pilot.
The Oxfordshire Early Supported Discharge (EDS) service for stroke helps patients by continuing their rehabilitation in their home after they leave hospital, providing them with the same level of rehabilitation at home as would be delivered on an inpatient Stroke Unit.
The six-day-a-week service, provided for free by the Trust, helps stroke patients return to normal, daily activities such as walking, shopping, reading, cooking, and driving.
One of those to benefit from ESD, which was introduced by the Trust in 2018, was Carole Joines from Banbury.
The 56-year-old was out walking her two dogs in a nearby village when she had her stroke in November 2018.
Feeling tired and unaware she had had a stroke, Carole was persuaded to go to hospital by her husband Keith. She attended the Horton General Hospital in Banbury and was immediately blue lighted to the John Radcliffe Hospital in Oxford.
Carole remained at the John Radcliffe for six days before relocating to her mother’s house, also in Banbury, for two weeks via the ESD pathway.
Delighted to be in more familiar surroundings before Christmas, Carole said: “I only slept downstairs for three nights before I could manage the stairs. The physios were fantastic and came every day for six weeks.
“After they had discharged me I got a terrible cold that really took its toll on me, but I am now walking my dogs for an hour – two miles – every day, and feeling a lot better.
“The help I received for my six weeks of ESD care was brilliant. It helped me teach myself everyday things, such as dressing myself, walking properly, getting up the stairs, and to bathe myself again. I hope to continue my progression as I feel stronger every day.
“I can’t thank the ESD team enough.”
ESD was commissioned by the Oxfordshire Clinical Commissioning Group (OCCG) in early 2018 following a consultation in 2017. The Trust had previously run a pilot version of the service, but it was fully commissioned just over a year ago.
Part of the OCCG’s initial consultation on health services in the county was to secure an improvement in outcomes for stroke patients.
The proposal was to take all suspected stroke patients in Oxfordshire to the Hyper Acute Stroke Unit at the John Radcliffe for the quickest, most specialist care possible. This, while also being supported by the county-wide rollout of ESD, is a positive outcome from the consultation with benefits for patients across Oxfordshire.
The good news is that the service is run out of the John Radcliffe Hospital, and now has satellite offices at the new hub at the Horton General Hospital in Banbury, as well as one at the Trust’s base at Cowley, Unipart. The trio of centres enable us to provide an efficient service to the entire county.
National guidance says at least 30 percent of discharges from Stroke Units to home should be supported by ESD – the Trust is currently supporting about 50 per cent of discharges.
In addition, ESD has played a vital role in helping patients avoid an otherwise necessary admission to hospital by delivering the required therapy at home.
Overall, 307 patients received therapy in their own homes provided by ESD in its first year.
Most patients’ health stabilises after a stroke, and at a certain point they may not require medical input – instead, they might need therapy in order to get the best outcomes and recovery after their stroke.
Therapy doesn’t always need to be in a hospital and, with the service provided in the home, appropriate patients can achieve the same level of function or better than if they were rehabilitating on a hospital ward.
This has the additional benefit of helping patients to relearn how to do things – such as walking and cooking – in a more appropriate environment. This maximises their chances of returning to functioning independence while in a familiar environment.
Carly Elphick, Team Lead Physiotherapist and part of the ESD team at Oxford University Hospitals NHS Foundation Trust, said: “The take-up of this service has been enormous, and has enabled more patients to return to their own home for rehabilitation in a familiar environment – as quickly as possible after their strokes.
“The other huge bonus is that expansion of the service means the post-stroke therapy provided at home is now more equitable across the whole county.”
James Kennedy, Clinical Lead for Stroke Services at the Trust, said: “Enabling stroke patients to receive the care they need in the best location to deliver it was the key consideration of the OCCG’s consultation.
“We are delighted to have worked closely with all partners to deliver ESD across the whole county, getting more patients home faster to receive the appropriate therapy at home, where they need to learn to adapt to life following stroke, rather than the artificial surroundings of a hospital ward.”
Dr Ed Capo-Bianco, Oxford Clinical Commissioning Group's South East Locality Clinical Director and lead on access to urgent care, said: "The Early Supported Discharge service has brought huge benefits to patients across the county.
“Most people prefer to continue their stroke recovery and rehabilitation at home with intensive support from our excellent team of therapists and most people do better as a result. ESD is a real success story."
The Trust’s ESD team is made up of stroke consultants, physiotherapists, occupational therapists, speech and language therapists, dietitians, and rehabilitation assistants.
OUH marks successful service anniversary
- Date:08 July 2019