National Stroke Strategy

Lord Lisvane Excerpts

Wednesday 18th November 2015 Lords Chamber

[Lord Lisvane (CB)]

My Lords, I should preface my remarks with a declaration: I am the patron of Herefordshire Headway, which provides services to adults who have a head injury or an acquired brain injury. It does marvellous work through its day centre, offering a range of activities and therapies led by specialists.

I warmly endorse the view of the noble Baroness, Lady Wheeler, that there needs to be a continuing national strategy, and I suggest that an important emphasis must be on increased resources for rehabilitation. I was delighted to hear what the noble Lord, Lord Lansley —I hope that, in view of our former happy and close working relationship, I may on this occasion call him my noble friend—said about funding at the point of discharge and thereafter.

In terms of rehabilitation, there needs to be greater availability of physiotherapy. Frequently, that is only 30 minutes or so a week, which clearly is simply not enough. Repetitive movement of affected limbs may well help the development of new brain pathways and connections. The improvement of robotic machines to help in this will play an important part, but once again resources are key. It is a real challenge for people to do the hard slog of rehabilitation on their own. Group support can make a real difference. Here again rehabilitation centres where that group support is available have an important part to play. There is a lot of scope for much greater joint working between the NHS and rehabilitation centres such as Headway, and for joint funding between health and social care. Rehabilitation after stroke helps people rebuild their lives, and the lives of their families. That in itself should be a strong argument for it to be a spending priority. But also it is the wider community that benefits, and faster and more effective rehabilitation leads to savings in other areas as well, as my noble friend Lord Kakkar pointed out a few minutes ago.

Point 7 in the original strategy’s 10-point plan for action is spot-on in seeking to ensure that,

“health, social care and voluntary services together provide the long-term support people need”.

It asks:

“Is commissioning and planning integrated across the whole care pathway in your area?”.

Spot-on indeed, but has it really happened?

If availability of longer-term support through the charities, with their low overheads and costs per hour, could be built into the national stroke pathway then CCGs would be encouraged to commission the most appropriate providers in their area. I am confident that we would thereby get more for less.