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Mid-Nottinghamshire Directory of Community Stroke Services A guide for stroke survivors, families and carers in Mid-Nottinghamshire January 2016 CONTENTS Purpose and aim of this guide 2 Why I might need community stroke services after leaving hospital 3 Using the guide 4 Clinical Commissioning Group Map showing Mansfield & Ashfield and Newark & Sherwood CCGs (referred to as Mid-Nottinghamshire) 5 List of Mid-Nottinghamshire General Practices/Doctors 6 Information for patients living in Mid-Nottinghamshire 8 When a Stroke Happens – a ‘typical’ journey through Acute and Rehabilitation stroke services 9 Stroke pathway illustration 12 Examples of other common stroke care pathways 13 Appendix of stroke services available in Mid- Nottinghamshire 14 1 PURPOSE AND AIM OF THIS GUIDE Leaving hospital can be an anxious and confusing time. The aim of the guide is to help identify community services available beyond leaving hospital. Community stroke services are varied and access to them is dependent on which area of Nottinghamshire you live in and in which Clinical Commissioning Group your General Practitioner/ Doctor is situated. The East Midlands Academic Health Science Network has produced this guide for the benefit of stroke survivors, families, friends and carers living in Mid-Nottinghamshire. 2 WHY I MIGHT NEED COMMUNITY SERVICES AFTER LEAVING HOSPITAL There is research evidence to show that stroke survivors benefit from stroke specialist rehabilitation delivered by a stroke specialist multidisciplinary team. This is particularly true for ‘Early Supported Discharge’ (ESD) services. ESD services facilitate early transfer of care from hospital to home and provide intensive rehabilitation in the home environment, to aid better and faster recovery. There is also evidence to show that extending community stroke specialist rehabilitation beyond the length of an ESD service, for stroke survivors who need it, has proved beneficial. It is important to note that some patients may not experience the exact pathway explained in this guide and take different routes depending on individual needs. 3 USING THIS GUIDE Healthcare for patients living in Mid-Nottinghamshire is commissioned by Mansfield & Ashfield and Newark & Sherwood Clinical Commissioning Groups. Check your General Practitioner or Doctor is listed and falls within the Mid-Nottinghamshire boundaries on the Clinical Commissioning Group map and then continue through the guide for information on community stroke services available. Please note that the information included in this pack was accurate at the time of print. Services may have since been re-commissioned, in which case your GP should be able to advise you on current services available to you. 4 CLINICAL COMMISSIONING GROUP MAP SHOWING MANSFIELD & ASHFIELD AND NEWARK & SHERWOOD BOUNDARIES Mansfield & Ashfield (dark blue) and Newark & Sherwood (green): Annesley, Balderton, Bilsthorpe, Blidworth Clipstone, Collington, Edwinstowe, Farnsfield, Huthwaite, Jacksdale, Kirkby in Ashfield, Mansfield, Mansfield Woodhouse, Meden Vale, Pleasley, Newark, New Ollerton, Pinxton, Rainworth, Selston, Shirebrook, Skegby, Sutton in Ashfield, Sutton on Trent, Warsop, Worksop 5 LIST OF GENERAL PRACTITIONERS AND DOCTORS A Acorn Medical Practice, Ashfield House, Ashfield Medical Centre B Balderton Primary Care Centre, Barnaby Gate Surgery, Bilsthorpe Surgery, Blidworth & Ravenswood Surgeries, Brierley Park Medical Centre, Bull Farm Primary Care Centre C Clipstone Health Centre, Collington Medical Centre D Doctors Ward Pearce & Partners (Churchside Medical Practice) F Farnsfield Surgery, Forest Medical Group - Rosemary Street Health Centre and Oak Tree Lane Surgery H Harwood Close Surgery, Healdswood Surgery, Hill View Surgery, Hounsfield Surgery J Jacksdale Medical Centre K Kirkby Community Primary Care Centre, Kirkby Family Medical Centre, Kirkby Health Care Complex, Kirkby Health Centre, Kirkby Surgery L Lombard Medical Practice 6 M Major Oak Medical Practice, Meden Medical Services, Middleton Lodge, Millview Surgery O Oakwood Surgery, Orchard Medical Practice P Pleasley Surgery R Rainworth Health Centre, Riverbank Medical Services, Roundwood Surgery S Sandy Lane Surgery, Selston Surgery, Southwell Medical Centre, St Peter’s Medical Practice T The Foundation Medical Centre W Willowbrook Medical Practice, Woodlands Medical Practice, Woodside Surgery 7 INFORMATION FOR PATIENTS LIVING IN MID-NOTTINGHAMSHIRE Stroke survivors living in Mid-Nottinghamshire will most typically follow the journey below: Following admission to the Stroke Unit at Kings Mill Hospital, assessments by the specialist team will be completed and rehabilitation will begin, working towards discharge from the hospital with you and your family. An Early Supported Discharge Service provides stroke rehabilitation in your own home and so allows you to leave hospital early. For those patients who are not eligible for this service, rehabilitation will continue in hospital and as your recovery progresses you will be transferred to an outpatient rehabilitation service. Outpatient Physiotherapy and Occupational Therapy services are delivered by teams based at Kings Mill Hospital, Mansfield Community Centre or Newark Hospital. Speech and language therapy service is delivered by a team based at Mansfield Community Centre. In order to be eligible to receive these services you must be registered with a Mid-Nottinghamshire GP and meet certain requirements specified by the services. 8 WHEN A STROKE HAPPENS STROKE UNIT - KINGS MILL HOSPITAL HYPER ACUTE STROKE UNIT AND CONTINUE STROKE UNIT REHABILITATION Admission to hospital Getting you well enough to leave hospital Assessment and Thinking about what you, your management by a family and friends can do to help specialist stroke team Quick access to brain PLANNING TO LEAVE THE HOSPITAL scan and other tests Plans for your discharge from hospital will Some patients may go include you, your family, and might involve the straight home from the Early Supported Discharge Team, Social Hyper Acute Stroke Services and Outpatient Therapy Unit This includes making plans for: Practical Help Any equipment you may need Support from your carer and family Support from other people who have had a stroke Any ongoing rehabilitation Social care Assessment or review Some patients may go straight home from the Hyperacute Stroke Unit 9 WHEN A STROKE HAPPENS REHABILITATION AND ADAPTING TO LIFE AFTER STROKE REHABILITATION AT HOME You may be seen by: Therapy Staff Social Care Staff The Stroke Association Support Worker Support Services Voluntary Organisations or Charities Help from your GP 10 Local Support: Information, Advice and Support is provided by The Stroke Association, (Tel: 01623 622515 extension 3690 or 07957 718382). The national Stroke Association also provide a ‘Need to Talk’ Helpline: (Tel: 0303 3033 100). Strokeability is a 12 week gentle exercise programme which is available subject to sufficient referrals. For further information contact:Adult Social Care, West Bridgford, Nottingham, NG2 7QP (Tel: 0115 9772546 or 07793977985). Regaining Confidence After Stroke – a 10 week course offered in the first two years after stroke to support adjustment to change. (Tel: 01623 673302 or email: [email protected]). Other Useful Contacts: The Government website Department for Work & Pensions is a useful online resource providing information and advice on carer and disability benefits. Information on driving can also be obtained from this website. (Website: www.gov.uk) Different Strokes is a charity supporting stroke survivors, families and friends and provides advice on how to get help from social services. (Website: www.differentstrokes.co.uk) 11 STROKE PATHWAY ILLUSTRATION This diagram provides an overview of a ‘typical’ stroke care pathway. The term ‘pathway’ refers to a system of stroke services as recommended by research evidence. A ‘typical’ journey experienced by a stroke survivor starts with admission to a hospital (referred to as acute stroke services) then continues through community based rehabilitation and social care services. These services are provided by Clinical Commissioning Groups or local authorities and are delivered by a variety of service providers. The diagram was drawn by Ossie Newell who is a stroke survivor and was created by the East Midlands Academic Health Science Network Stroke Programme. 12 EXAMPLES OF OTHER COMMON STROKE CARE PATHWAYS The pathway of care experienced by each stroke survivor will be different, based on their particular needs and what services are available in the area they live. The flowcharts below give examples of some common pathways – these are also ones that research evidence says are most effective. Hospital Acute Hospital Acute Hospital Acute Ward Ward Ward Hospital Go Home Hospital Rehabilitation Wards Rehabilitation Wards Go Home Go Home Early Supported Early Supported or to a Care Discharge Service Discharge Service Home Community Stroke Community Stroke Community Stroke Rehabilitation Service Rehabilitation Service Rehabilitation Service 13 APPENDIX OF STROKE SERVICES AVAILABLE IN MID-NOTTINGHAMSHIRE Stroke Unit, Sherwood Forest Hospitals NHS Foundation Trust Kings Mill Hospital, Mansfield Road, Sutton in Ashfield, Nottinghamshire, NG17 4JL. Telephone: 01623 622515 extension 3050 Early Supported Discharge Service, Sherwood Forest Hospitals NHS Foundation Trust, Concorde Way, Bull Farm Primary Care Centre, Concorde Way, Mansfield, Nottinghamshire, NG19 7JZ. Telephone: 01623 672112 Rehabilitation Outpatients Service,
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