Consultant Stroke Physician Royal Bournemouth Christchurch NHS Foundation Trust

3. Life After Stroke Only around half of individuals who have experienced a stroke receive the rehabilitation to meet their needs in the first six months following discharge from hospital, falling to around one fifth in the following six months Three-quarters of younger individuals want to return to work A third develop depression A third experience communication difficulties About one third of people who have strokes will die as a result; many of these will not do so immediately, but within three months of the stroke

4. This is how people with stroke and aphasia conceptualised the current situation and how they wanted it to change: The top of the slide � the �before� scenario - shows that in the acute stage they do get quite a lot of help from therapies etc, but no one really helps them deal with the fact that they are going to be disabled, their lives have been turned upside down and no one can communicate with them (often least of all health and social care staff). And in the longer term, there is no help at all usually In the �after� scenario � at the bottom of the slide - people should get the full range of help and support they need in the early days, plus a rich menu of opportunities to move on to over the long term This is how people with stroke and aphasia conceptualised the current situation and how they wanted it to change: The top of the slide � the �before� scenario - shows that in the acute stage they do get quite a lot of help from therapies etc, but no one really helps them deal with the fact that they are going to be disabled, their lives have been turned upside down and no one can communicate with them (often least of all health and social care staff). And in the longer term, there is no help at all usually In the �after� scenario � at the bottom of the slide - people should get the full range of help and support they need in the early days, plus a rich menu of opportunities to move on to over the long term

6. UK has Poor International Performance

10. Stroke Risk After TIA and Minor Stroke is Substantial and Immediate

11. Workforce: Key facts No nationally-recognised stroke-specialist courses or competences for nurses or AHPs Many staff in traditional unidisciplinary roles without training in leadership and effective teamworking

12. Working Together National Consultation Approaching 1000 responses 800 from stroke survivors or carers National Support

13. Messages from the National Consultation Transition from hospital to home Happy with acute care mostly but felt abandoned once back in the home Importance of up-to-date information such as what services are available to them and where to find out about them Many �what happens next� questions Many requests for early engagement with social care Particular issues for minority groups

14. People with communication difficulties Major issue requiring time and special attention �Give people time to understand and respond� was a recurring message Some care providers often made assumptions about individual wishes and choices

18. Vital Signs % stroke patients who spend 90% of their time in hospital in a stroke unit % of high risk TIA patients who are treated within 24 hours

19. Vital Signs - Quarter 2 ReportingEngland

20. Vital signs - Quarter 2 reportingSHA East of England

21. Networks Support Joint Working Enhanced contact with commissioners, SHAs, Local Authorities and Voluntary Sector Opportunities for new conversations across conventional boundaries Different geographies have different challenges�and solutions!

22. Bridge to commissioners Guide commissioning process Delegated commissioning authority