An investigation into the effects of Omicron and winter pressures on stroke rehabilitation services across the East of England

ABSTRACT

Introduction: A service impact assessment was undertaken to understand the influence of winter pressures and omicron on stroke rehabilitation service delivery in November and December 2021. This followed concerns regarding rehabilitation provision raised by clinicians and stroke service managers including acute providers, community in patient teams and early supported discharge (ESD) teams across the East of England. Method(s) Questionnaires were distributed to all acute, community and ESD stroke services within the North and South Integrated Stroke Delivery Networks (ISDN), covering physiotherapy, occupational therapy, speech and language therapy and psychology disciplines. Ratings were made against the key themes that had been raised anecdotally as concerns to service delivery. (0=no impact, 1=some impact 2=significant impact) Follow up meetings were arranged for each Integrated Care System (ICS) to provide narrative around the rated themes. Allied Health Professional (AHP) representatives from each stroke service within the ICS were invited to these meetings. Finally, the ratings and narrative were taken back to the Rehabilitation Clinical Advisory Group (CAG) for solutionbased discussions to formulate a potential action plan to report to the Clinical Reference Group (CRG). In total 61 responses were received from professional leads across the four disciplines. Result(s) Issues, themes and recommendations have been established relating to * Workforce. * Increased referral rates and caseloads. * Rehabilitation Intensity. * Access to care packages and equipment. * Visiting arrangements and the direct impact on discharge planning. * Perceived patient and family experience. Conclusion(s) Analysis is ongoing;however, ten recommendations are being prepared to enable increased robustness of service delivery in preparation for next winter.