Basildon University Hospital,
Nethermayne, Basildon, Essex, SS16 5NL
Who the service is for
All adults over 18 years of age who have had an acute stroke.
About the service
When a patient has a stroke they are first seen in our accident and emergency (A&E) department, where there are six stroke specialist nurses on-call 24/7, providing thrombolysis assessment and initial rapid brain imaging.
The stroke specialist nurses will then facilitate moving the patient to Pasteur Ward, where they will receive hyper-acute care for the first 72 hours after the stroke. Care and therapy from a range of healthcare professionals starts as soon as the patient is admitted to the ward and is medically stable. Pasteur Ward offers an intensive acute rehabilitation programme tailored to individual needs.
When patients are well enough they will be discharged home or transferred to Lister Ward if more rehabilitation is required. Lister Ward has dedicated nurses, occupational therapists, physiotherapists, speech and language therapist and a full time clinical physiologist, so that each patient’s goals and therapy can be tailored to meet their individual needs.
‘One stop’ TIA clinic
The ‘one-stop’ TIA clinic offers patients who are thought to have had a TIA, rapid access to investigations and diagnosis in one visit. Patients can be referred to the clinic by A&E or by their GP.
The clinic runs every day, when new appointments are held in the morning with a follow-up appointment in the afternoon.
The assessment is carried out by a specialist stroke consultant, with tests including MRI and carotid doppler scans, performed if required.
Inpatient stroke physiotherapy
Our team of physiotherapists are experts in the assessment and treatment of movement disorders commonly associated with stroke. Physiotherapy aims to restore functional movement, reduce impairment and maximise quality of life after a stroke.
As having a stroke frequently affects a patient’s ability to move, a central aim of the stroke physiotherapy team is to promote the recovery of movement and mobility. Physiotherapists work with other members of the healthcare team to implement individualised treatment plans for patients, to address specific problems.
Key elements of the patient-specific treatment may involve:
Individual exercise programme
Individual treatment programme
Our team of physiotherapists work with each patient to develop short and long-term goals, and involve family members and carers and in the rehabilitation process from the very beginning.
When a patient is admitted to Lister Ward, they will be assigned a key worker. They are responsible for guiding rehabilitation, planning discharge, liaising with community services and patients’ families.
The stroke units also have close links to community-based services that will aim to further progress patients’ functional abilities when they are discharged home from hospital.
Should you wish to enquire about treatment plans, progress or any aspect of a patient’s physiotherapy, please speak to the ward clerk and an appointment can be arranged.
Inpatient stroke occupational therapy
After a stroke, patients will have occupational therapy as part of their rehabilitation to develop their ability to do day-to-day tasks like toileting, grooming, eating, cooking, washing and dressing.
Our team of skilled occupational therapists address the physical, cognitive and emotional changes that can occur after a stroke. They use functional tasks to help patients strengthen their abilities, develop skills and relearn new ways of doing things, to improve confidence.
Inpatient occupational therapy may involve:
- Assessment of functional skills- assessing physical, cognitive or emotional/behavioural difficulties which may limit the patient’s ability to carry out day-to-day tasks.
- Individual treatment programme- Setting goals, practicing activities and using strategies and techniques to maximise the patient’s independenceand the ability to carry out the activities of daily living.
- Discharge planning- Home visit /site visit to identify equipment or adaptations required to ensure safety when the patient leaves hospital.
- Support services- Suggesting short term/ long term packages of care, referring to community-based stroke service for continuity of rehabilitation in home environment, providing information about support group for patient and carers.
Our occupational therapists work closely with patient and their families. We involve families at every stage of therapy process and can arrange joint sessions on request. As we are based on hospital ward, we are easy to approach or family members can contact the ward clerk for an appointment.
Inpatient stroke speech and language therapy
The Speech and Language Therapy (SLT) team assess and treat of a range of swallow, speech, language and communication disorders which can commonly occur after a stroke. The aim is to improve and maximise communication and swallow function, to improve quality of life.
We visit patients on the ward each day. Our support extends to the wider family, with advice and strategies that can be transferred from the hospital to home, to support patients to communicate successfully and to eat and drink safely, where possible.
Speech, language and communication disorders
The therapy provided is based on individual needs, and may include; targeting speech clarity, increasing language comprehension and improving word-finding abilities and verbal communication. We may also introduce alternatives such as iPads and applications, personalised communication books or computer-based systems for patients whose verbal communication is limited.
In some cases, a stroke can impact a patient’s ability to swallow food and drink safely. We will assess what the difficulty is and find ways this can be managed, for example with a modified diet or thickened fluids. Alongside this, we may also provide therapy to strengthen the muscles used in swallowing. We work closely with the medical team and dieticians to ensure all patients meet their nutritional and hydration requirements.
The hospital stroke services also have close links to community-based services, to ensure continuity of care when the patient leaves hospital.
Inpatient stroke clinical psychology
After a stroke many patients find that not only their body but also their emotional well-being and cognitive functioning have been affected. Psychological difficulties after a stroke are common and include depression, anxiety, adjustment difficulties and cognitive problems such as reduced memory, attention, and reduced decision making/planning skills.
Working jointly with other therapists, the clinical psychologist assesses patients who have had a stroke for the above difficulties, and provides short-term support where needed. They also ensure that, after discharge, patients are referred to appropriate services for further therapy if appropriate.
The clinical psychologist works directly with patients using a range of therapeutic approaches. This includes helping patients to understand their stroke and its effects, supporting emotional adjustment, anxiety management and overcoming lack of motivation to engage in rehabilitation. Practical ways to retrain attention and decision making skills are also provided. They may also be involved in the assessment of mental capacity.
The clinical psychologist also works with therapy staff including physiotherapists, occupational therapist, speech and language therapists and dieticians, to help patients meet their rehabilitation goals.
Inpatient Stroke Dietitians
Having a stroke can cause psychological, behavioural and physical changes, which may affect a patient’s eating and drinking. These include changes in mood, problems with perception (awareness), difficulties communicating, drowsiness and weakness. A patient’s swallowing may also be affected, which can be for a short time or longer term.
We have a team of dietitians who are qualified health professionals who assess, diagnose and treat diet and nutrition problems. Each patient will be assessed on admission to hospital, and during their stay, to see if they are at risk of malnutrition. If appropriate, they will be referred to a dietitian to help meet their nutritional requirements.
The dietitian will:
- Assess patients who are malnourished or at risk of becoming malnourished
- Provide diet advice and care plans to help meet each patient’s nutrition and hydration needs
- Prescribe nutritious drinks, soups and desserts to supplement diets which are low in nutrients
- Provide care plans for patients who require tube feeding (putting liquid food directly into the digestive system through a tube)
- Provide advice for patients on a texture modified diet (food that has been prepared to make it easier and/ or safer to swallow)
If a patient still requires help with their nutritional needs when they leave hospital, they may be referred to the community dietetic service in their local area.