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