Issue - meetings

Jacqui Van Rossum, NELFT, declared a non-pecuniary interest in this item.

Dr Ravi Goriparthi presented the report on behalf of the Clinical Commissioning Group, and explained that stroke is the largest cause of complex disability and that 30% of sufferers would require community stroke rehabilitation services.  The level of care provided would have a significant effect on recovery and therefore the future quality of life of the individuals.  An ageing population also increased the risk of stroke occurrence.  Whilst the outcomes in hospital were good, the level of care and provision upon discharge were inconsistent.

Improving the pathway for post-acute stroke care was one of the Clinical Commissioning Group (CCG) priorities for 2015/16 and a BHR Stroke Pathway Transformation project had been established to ensure that people who have had a stroke achieve the best possible outcomes.  Following an analysis of data from both acute and community providers, a service mapping exercise and stakeholder engagement, an case for change had been developed. 

The Board raised a number of issues, including:

·  Noting that the Health and Adult Services Select Committee (HASSC) were also looking at this issue at its next meeting.

·  Rehabilitation is usually best within a patients home, rather than in a hospital environment.

·  The suspected problems within the service provision had now been confirmed by data.  This had indicated a complexity of pathways and that in some areas there was limited access to monthly reviews and inconsistencies of record keeping.

·  Partners could now jointly look at how changes could be made to improve outcomes and the development of a joint pathway and how this pathway would be organised across the bigger geographical area.

·  The resource implications for the NHS and the potential costs on Adult Social care.

·  The Health Service commissioning was now less fragmented; as a result Partners would need to jointly decide what was required to improve outcomes.  A draft outline business case would be drafted to enable consultations to commence with HASSC and the wider community. 

Having considered the issues, the Board:

(i)  Agreed that there was a clear case for change for stroke rehabilitation care;

(ii)  Agreed that stroke rehabilitation care and outcomes needed to improve;

(iii)  Agreed to continue to engage with Barking and Dagenham Clinical Commissioning Group on improving stroke rehabilitation care; and

(iv)  Noted that a further report would be presented to the Board in December 2015 / January 2016 on the business case for service improvement.