Service detail

The stroke early supported discharge (ESD) team see mild to moderate stroke survivors for intense rehabilitation at home for up to 6 weeks after they have left hospital.

These county-wide specialist neurological rehabilitation services are available to all patients/clients who are aged 18 years old and over who have a complex neurological condition. This may include people with neurological conditions that have a sudden onset such as stroke or acquired brain injury, as well as those that have chronic, long-term and progressive conditions such as multiple sclerosis.

They work as a multidisciplinary service with physiotherapists, occupational therapists and rehabilitation assistants, They also have some access to psychology support.

The neuro rehabilitation teams work closely alongside the speech and language therapy teams. It now includes a new service which helps patients who are admitted to hospital following a mild stroke to recover more quickly.

The stroke early supported discharge (ESD) team helps those admitted to acute stroke units located at Addenbrookes Hospital, Peterborough City Hospital, Hinchingbrooke Hospital and Queen Elizabeth Hospital Kings Lynn, to be discharged sooner by providing by up to six weeks rehabilitation, either to their home or in a community ward.

The 24-strong team is made up of nurses and therapists who are specially trained in stroke care. Benefits of the services can include:

• Promoting independence and self management, enabling patients to live at home through the provision of a range of support and therapeutic services.
• Improve outcomes and experience for patients. Improving quality of life including support for returning to work.
• Creating access to better, more integrated care outside of hospital.
• Developing ways of coping with problems arising from their condition Enabling patients to understand their condition.
• Enabling patients to be discharged from hospital or avoid a hospital admission through the provision of support in the home setting.
• Providing specialist education and training to generalist therapy staff on neuro-rehabilitation.

They work closely with specialist nurses, hospital consultants, social care, and other services such as Evelyn Community Head Injury Service and Oliver Zangwill Centre to provide co-ordinated, holistic care. They will undertake a comprehensive assessment and agree a plan for your rehabilitation needs based on what you want to achieve.