Increasing access to therapy

There is much diversity across the shape, content and delivery of rehabilitation and therapy services across England and this presents a challenge for both service improvement and research within this field. More latterly, the NICE quality standards for stroke and rise to  prominence specifically of the 45 minutes of therapy has heightened the focus on therapy services and how they work, without a corresponding increase in new tools to support them with managing the challenges it has created. Work with therapy project teams across three years on two national projects has shown the benefit of applying systematic service improvement analyses to their functioning, processes and patient outcomes. Work included using the demand and capacity tool to support service improvement work to increase access to therapy, enhance and spread a rehabilitation culture and identify additional service needs.

This webpage includes the learning from this work that is directly related to the application of demand and capacity for stroke therapy services, with some additional useful information around the evidence base, data collection and other approaches being adopted to improve access to therapy and rehabilitation.
 

• Measuring therapy services
  An overview of information and tools you may find useful in measuring your therapy service.
   
• Effective use of technology
  Information and best practice of how people have used technology effectively to assist the rehabilitation of stroke patients
  
  
• Standards, guidelines and evidence
  Many standards and guidelines for therapy services exist to guide the direction for the development of services to improve access to therapy.
    
  
• National stroke data and audit
  More data is emerging about the improvements in access to therapy, including National Sentinel Audit reports. This presentation from June 2011 on the National Sentinel Audit Round 7 includes information on 45 minutes of therapy.
    
   
• Frequently asked questions
  Beginning the process of improving access to therapy, and considering how to apply the guidelines to practice, raises a number of common questions. This document has been collated using the evidence papers, research and consultation with many key stakeholder groups and may help with local discussions. A full list of stakeholders can be found at the back of the publication Mind the gap: ways to enhance therapy provision in stroke rehabilitation.
    
   
• Examples of practical work to increase access to therapy
  Case studies of work carried out by project sites across England.
   

NHS Improvement - Stroke has produced two publications following national project work from 2009 to 2011, including work related to therapy provision for stroke survivors. The 2011 publication, Mind the gap: ways to enhance therapy provision in stroke rehabilitation, explores work with eight project teams, all implementing new models for achieving seven day working, or 45 minute therapy sessions.

The first publication in 2010, Going up a gear: practical steps to improve stroke care, includes the learning from three teams involved with the national rehabilitation projects working to achieve the aspirations of quality marker 10 of the National Stroke Strategy.  More detailed case studies from the three teams, Aintree University Hospitals NHS Trust, NHS Medway and York Hospitals NHS Foundation Trust, can be found in the supporting document Improving post hospital and long term care: case studies from the Stroke Improvement Programme projects.

Contact
Jill Lockhart
National Improvement Lead
NHS Improvement - Stroke
Email: jill.lockhart@improvement.nhs.uk