Service overview - Stroke services
Our stroke services work across our mid Essex hospitals, providing the best possible care and clinical excellence for our patients.
A stroke is a serious life-threatening medical condition that happens when the blood supply to part of the brain is cut off.
Strokes are a medical emergency and urgent treatment is essential. The sooner a person receives treatment for a stroke, the less damage is likely to happen.
If you suspect that you or someone else is having a stroke, phone 999 immediately and ask for an ambulance.
AttendAnywhere video consultations for patients
We've introduced video appointments to help us carry on seeing patients during the current coronavirus pandemic.
Many of our services are now using this resource. Visit our AttendAnywhere page to find out more and to watch a short video, which will help you understand how these video appointments will work.
Basildon Hospital - Stroke services
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.
Broomfield Hospital - Stroke services
The Stroke Service team here at Broomfield have been recognised by the Excellence in Stroke Care Awards.
A stroke can have devastating effects for a patient, every second a stroke goes untreated, 32,000 neurons die.
As a stroke evolves over a period of 10 hours this will lead to the patient losing approximately 1.2 billion neurons, equating to ageing 3.6 years for every hour, a total of 36 years on average!
The excellent work in the door to needle figures, assessing and treating suspected stroke victims to combat the effects of a stroke has resulted in the East of England Excellence in Stroke Care Award Scheme, with the first awards presented at the 2012 conference.
What is a Stroke?
A stroke is a ‘brain attack’ caused by a disturbance of the blood supply to the brain. There are two main types of stroke, which require different types of treatment:
The most common form of stroke. It is caused by a clot narrowing or blocking blood vessels so that blood cannot reach a particular area of the brain. This leads to the death of brain cells due to lack of oxygen.
Caused when a weakened blood vessel in the brain bursts. This produces bleeding into the brain, which leads to damage.
What is a TIA?
Transient ischaemic attack (TIA) is also called 'mini-stroke'. It is similar to a stroke and has the same signs, but gets better within 24 hours. However, it could be a warning sign of a more serious stroke and it is vital that it gets the same F.A.S.T. action by calling 999.
The team are located on the Stroke Unit, A302.
Southend Hospital - Stroke services
Acute stroke unit
Our dedicated stroke unit comprises 14 acute stroke beds on Benfleet ward and 26 stroke/neuro-rehabilitation beds on Paglesham ward, and offers a 24-hour thrombolysing or 'clot-busting' service and we are able to provide a brain scan within the first 24 hours of the stroke.
This procedure dramatically increases the chance of recovery following an attack. Our unit has emergency and rehabilitation wards side-by-side, a purpose-built gym and the Jack King patient information centre.
Symptoms of a stroke can include:
Paralysis or weakness of one side of the body
Dysarthria - muscles of speech impaired causing slurring
Dysphagia - muscles of swallowing impaired
Visual deficits - double vision, decreased visual acuity
Sensory impairment - absent or diminished response to touch, pain, pressure
Dysphasia - difficulty in expression and/or comprehension
Intellectual impairment - memory loss, poor judgement or reasoning
Our multidisciplinary team provides a great stroke rehabilitation service. We base our care on the National Clinical Guidelines for stroke. We have a large multidisciplinary team consisting of many professionals specialising in stroke care including occupational therapists, physiotherapists, speech and Language therapists, dietitians and stroke support workers. Each professional brings their specialised knowledge to ensure a holistic approach to the rehabilitation of each patient.
Transient Ischaemic Attack (TIA) clinic
We currently run our TIA clinic in the day assessment unit, situated on the ground floor of the Prittlewell Building. The clinic runs weekly from Monday to Friday and aims to reduce the risk factors for stroke. We are able to access a range of diagnostic tests including ECGs, phlebotomy and carotid Doppler scan slots. Our aim is to identify the risk factors for each patient and ensure that treatment is optimised to reduce the risk as much as possible. Our staff can give information on healthy life style changes such as diet, exercise, alcohol consumption and giving up smoking, all of which can help reduce the risk of stroke.
As we aim to carry out as many of the tests and assessments possible at the TIA clinic, it does mean that you may be at the hospital for several hours. If possible we advise that you bring along anyone who witnessed the event leading to your referral to the clinic, as well as a list of your current medications.
Stroke support team: 01702 385381
Paglesham ward: 01702 385187
Benfleet ward: 01702 385471
Day assessment unit: 01702 385371