‘Life After Stroke Services’ Paul Underwood Deputy Director & Head of Operations, Wales Stroke Association Transitional, On-going & Follow-up Support

Having a Stroke is Bad Enough… As we are all aware: Stroke has a massive and sudden impact. It affects people physically and emotionally. Many Stroke survivors grieve for the life they had and fear they will never come to terms with their new reality. Families and carers are often shocked and feel isolated as they struggle to deal with the impact of Stroke; often unaided. Although people can recover from Stroke with the right support, too many survivors are written off and denied their right to recovery.

Stroke Information & Support Service Working Towards Empowerment & Achieving Functional Goals to Aid Social Reintegration – Follow-Up Support

Regular Reviews Patient, Family & Carer Have Responsive & Equitable Access to Services To Prevent Stroke & Empower Those Affected by Stroke to Reintegrate into Community Enabling an Optimum Quality of Life Inclusive of Carer Support Throughout Life After Stroke Driver Diagram [1] Stroke Information & Support Service plan Person-Centred Goal Plan(s) AimPrimary DriverSecondary Driver Match capacity to demand Match Capacity to Demand Individual journey diary Individual ‘Stroke Survivor Passport’ -Review- ‘Funder’ Acute Phase Rehab Phase Community Phase The Right Services on Offer Impact Survey ‘Client’ Access to Stroke Association Coordinator [1] Life After Stroke: Implementation Using Improvement Methodology Pilot Proposal & Mini-Collaborative (Adapted): NLIAH Working Draft, Sept 2012 Transitional Support

Stroke Information & Support Primary Prevention across multiple co-morbidities with parallel risk factors: Hypertension Atrial Fibrillation Cholesterol Diabetes Vascular Disease Obesity Smoking Cessation Alcohol Reduction Psychological & Mental Health Provision of ‘Secondary Prevention’ Information, Advice, Education and Support. Provision of Tertiary Support Services and on-going needs-led intervention. Vascular Risk Reduction

On-Going Support… What Do Individuals Affected By Stroke Say? Stroke Association ‘Needs Survey’, 2010

Emotional Support Community Follow-Up Mood Screening 73%79% 84% 80%

Emotional & Psychological Levels of Support in the Community * ‘Structured Rehabilitation’ is provided through Community Functional Rehabilitation

Stroke Information & Support Service One ‘integrated’ service throughout all 22 localities of Wales – IAS and Communication Support. Commencing in ABUHB on October 14 th Local Authority / Local Health Board funding boundaries would disappear based on the funding rationale. A realistic and mutually agreeable transition period now needs to be agreed to enable the successful roll-out of the service model – transition period commences in October 2013 (ABUHB). This would be achieved by staggering the service implementation on a LHB by LHB area – depends on the priorities referenced in each respective LHB Stroke Delivery Plan.

Funding calculations per County Council (U.A. area) and Local Health Board Locality are based on the prevalence / percentage of Stroke and TIA (QOF, 2010). Each Health and Social Care statutory partner would jointly and equitably contribute funding based on this rationale which would be divided on a 50/50 basis between each locality statutory organisation. Funding Rationale

Stroke Association Life After Stroke Services No Service Gaps U.A. Boundaries Would Disappear

Building the ‘Stroke Community’ in Wales Through transitional, on-going and follow-up support, we aim to ensure that the needs of all individuals affected by Stroke are always at the heart of everything we do. We aim to continue to expand our volunteers / supporters across all functions of the organisation to support these pathways and processes. We aim to strengthen our relationships with all organisations that support individuals affected by Stroke to promote social reintegration. We want to protect, grow and adapt our services providing equity and outcome-focussed services across all 22 localities.

Looking Forward…

We Believe a Better Future is Possible We believe that together we can change the world for people affected by Stroke. We believe in life after Stroke - that everyone has the right to make the best recovery they can from Stroke. We believe that research can save lives and ensure people make the best recovery they can. We believe Stroke can and should be prevented.

Our Promise to You!

Thank You