11:39am Wednesday 21st September 2011
By James Connell
STROKE rehabilitation is working far better in the community than it was in hospital and more services could now be moved out of the wards and closer to home in future, say health chiefs.
The Aconbury wing at Worcestershire Royal Hospital in Worcester is now closed and care is being provided at the city’s Timberdine Nursing and Rehabilitation Unit instead.
The centre is not used exclusively by stroke patients but other vulnerable groups, including elderly people who have suffered falls or are recovering from orthopaedic surgery such as hip replacements, chest infections, recurrent illnesses and problems caused by diabetes.
Leaders at NHS Worcestershire, who led the move to Timberdine, said they had made the right decision at their latest meeting.
Simon Hairsnape, the trust’s managing director, said: “At the moment all seems to be working well. The key aim of this piece of work was to close those wards because there was an inappropriate capacity.
“These patients should have been in community settings. That was fundamentally what the project was about.
“Those wards have been closed and care has been transferred to the community. It’s a case of so far so good.”
Mr Hairsnape said more services could be transferred to a community setting over the next three and a half years as part of an NHS programme to develop higher quality care.
Mr Hairsnape said the work has already resulted in decreased emergency admissions at county hospitals.
Dr Jonathan Leach, medical director and director of primary care, said feedback about the move had been ‘extremely positive’ as had discussions with GPs at the walk-in centre in Farrier Street in Worcester who are providing care for people at the rehab centre.
ACUTE STROKE CARE HEALTH bosses say they would like to create a single acute stroke unit at a Worcester hospital but are unable to because the site is so busy it is “over-heating”.
Eamonn Kelly, chief executive of NHS Worcestershire, said it had been a struggle to meet stroke standards in Worcestershire but that improvements had been made when he addressed the meeting.
At the moment acute stroke care is being developed at both Worcestershire Royal Hospital in Worcester and the Alexandra Hospital in Redditch but health chiefs have not ruled out a single site in future, preferably in Worcester.
National targets stipulate that 80 per cent of stroke patients should spend 90 per cent of their time in a dedicated stroke unit but this has happened only 71.2 per cent of the time so far this financial year, which is still an improvement.
Only 19 per cent of patients spent 80 per cent of their time in a dedicated stroke bed last April.
There are now 28 stroke beds in Worcestershire Royal Hospital in Worcester and the Alexandra Hospital in Redditch which are ring-fenced so they are exclusively for stroke patients. In December 2007 there were 23 stroke beds, none of which were ring-fenced.
Howard Eeles, a former councillor and shadow governor for the acute trust, raised concerns at the meeting about a decision to continue developing acute stroke care at both Worcestershire Royal Hospital and the Alexandra Hospital in Redditch when single, larger units appeared to enjoy better success.
Simon Hairsnape, the trust’s managing director, said improving stroke services had been a priority for the last two years but added: “There’s more to do.”
He said a clinical expert had backed the two-site model. He said: “There’s no reason to suggest we couldn’t have good, high quality acute stroke services at both hospital sites.”
He acknowledged there would be a clinical advantage to a single site but added: “At the moment we can’t deliver that because of capacity and delivery of other services.”
The question of centralising stroke services may be revisited at a later date, he said.
Mr Eeles, who referred to London having seven or eight larger acute stroke units, said: “I do have some concerns about having two smaller units in an area of this size.”
Mr Kelly said: “There’s a practical consideration at the moment. The preferred site would be Worcester for a single stroke service. At the moment that site is overheating in terms of the amount of activity were putting through that hospital.”
CASE STUDIES: IT’S MORE LIKE BEING AT HOME THAN IN A HOSPITAL
THE wife of a man who suffered a stroke has praised health bosses for developing stroke care in the community instead of in hospital.
Justin Butler, aged 53, of St Peter’s Drive, St Peter’s, Worcester, had a stroke on August 24 last year and spent six months in Worcestershire Royal Hospital in Worcester and being cared for at the Willows at Evesham Community Hospital.
As a result of the stroke he has speech problems, limited mobility down his right side, fatigue and problems with concentration.
His wife, Cathy, aged 49, said she could not fault the stroke care her husband received at either hospital but said Aconbury ward, where her husband spent six weeks, was not a suitable environment for the recovery of stroke and other vulnerable patients and she was glad an alternative had been found.
She said: “It’s a very old building. Unfortunately, for some unknown reason, someone decided to put the stroke unit on the third floor.
“With it being an old building, some of the time the lift didn’t work. I have seen an older gentleman in tears because he couldn’t get up the stairs to visit his wife. They didn’t want to take him in the lift in case it broke down.”
She said she hoped the Timberdine Nursing and Rehabilitation Unit was similar to the Willows and did not feel so much like a hospital.
Mrs Butler added: “When you’re stuck up on the third floor you can feel as though you’re isolated in a ward. It helps if you’re in the right atmosphere.”
Similar views were expressed by Tony Fallan, aged 46, of Westlands, Droitwich, during his stay at Timberdine.
He said: “It’s more like being at home than in a hospital and the nurses are more like family.”
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