03 tom greenwood seeing the whole of the stroke pathway.ppt
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Transcript of 03 tom greenwood seeing the whole of the stroke pathway.ppt
Two Stroke Pathways
Number 1: Where do Life After Stroke services sit on the Stroke
Care Pathway?
Orange area illustrates the importance of clinical issues for stroke survivor and
family
Blue area illustrates the importance of personal, social and community issues
for stroke survivor and family
Carer’s Support
Carer’s Support
Stroke Navigator
Pathway One!
Two Stroke Pathways
Number 2: Value For Money, Prevention and Wellbeing
Stroke Navigator
Life After Stroke Services
Community Integration, Lifestyle and Fitness
LAS
HASU
SU
Inpatient Rehab
Clinical Services
Active Citizenship
Re-ablement & Community Rehabilitation
SpecialistCare
Hi cost
Low cost
No cost
The inverted triangle of care Value for Money, Prevention and Wellbeing
Community Support
Source: All our tomorrows, - ADSS, LGA
Dependency
Restoring Independence
Preventing Deterioration
Independence and Choice
Stroke Navigator
Life After Stroke Services
Community Integration, Lifestyle and Fitness
LAS
HASU
SU
Inpatient Rehab
Psych/Clinical Services
Active Citizenship
Re-ablement & Community Rehabilitation
SpecialistCare
The inverted triangle of care Value for Money, Prevention and Wellbeing
Community Support
Source: All our tomorrows, - ADSS, LGA
Everyday Life £0/day
Sedentary lifestyle results in worse
mobilisation
Sedentary lifestyle results in worse
mobilisation
Family breakdown leading to depression
Family breakdown leading to depression
LAS £ 200/transfer
HASU £ 500/day
SU £ 200/day
Inpatient Rehab £ 150/day
Psych/Clinical Services £ 200/day
Generic Community Services £ 1/day
Days since stroke
Single patient pathway without specialist Third Sector Support
Additional Stroke as a result of poor diet &
exercise
Additional Stroke as a result of poor diet &
exercise
Cost: £7903
TIA resulting from continued smokingTIA resulting from continued smoking
Stroke Navigator
Life After Stroke Services
Community Integration, Lifestyle and Fitness
LAS
HASU
SU
Inpatient Rehab
Clinical Services
Active Citizenship
ESD & Community Rehabilitation
Hi cost
Low cost
No cost
Generic Stroke Services
The inverted triangle of care Value for Money Prevention and
Wellbeing
Healthy Lifestyle/Stroke Prevention £ 1/day
Stroke Navigator £ 10/day
Life After Stroke Services £ 2/day
Community Integration with Stroke Knowledge £ 1/day
LAS £ 200/transfer
HASU £ 700/day
SU £ 500/day
Inpatient Rehab £ 300/day
Psychological Services £ 200/day
Everyday Life £ 0/day
Re-ablement & Community Rehabilitation £ 50/day
Adaptations made to the home environmentAdaptations made to
the home environment
Peer support and social activities expand
horizons and confidence
Peer support and social activities expand
horizons and confidence
Single patient pathway with specialist Third Sector Support
Days since stroke
Fitness and Lifestyle prevent further strokeFitness and Lifestyle
prevent further stroke
Cost: £4990
Communication group improves relationships.Communication group improves relationships.
Lifestyle Advice & smoking cessationLifestyle Advice & smoking cessation
Comparison of Costs
• Generic Third Sector Support £7903
• Specialist Third Sector Support £4990
• Saving £2913
Two Pathways: Two Messages
1. Life After Stroke Services are not a pick and mix counter
They’re a coherent response to range of real needs, and an integral part to a stroke recovery pathway
2. Life After Stroke Services aren’t the icing on the cake
They save you money by helping people become and stay independent
Route 1 Route 2 Cost/unitLAS 1 200 2 1000 200HASU 3 2100 6 4200 700SU 10 5000 10 2000 500Inpatient Rehab
2 300 8 1200 300
Clinical Services
6 1200 300
Reablement 15 750 50Stroke Navigator
10 100 10
LAS Services 50 100 2Generic Community Services
103 103 1
Comm Integration
40 40 1
131 5440 6503