Rehabilitation Time Limited!

An audit of services for stroke patients by the Health Service Executive has found that 73% of hospitals are unable to provide adequate levels of rehabilitation therapy to those who need it.

The audit, which was conducted in conjunction with the Irish Heart Foundation, shows major nursing, medical and therapy staff deficits in stroke rehabilitation centres.
The incidence of stroke is rising by about 350 cases every year – a rise attributed to the ageing population.
This audit of 26 out of 29 rehabilitation units was carried out to examine the adequacy of services for patients after their initial period of treatment.
It found major deficiencies in vital recovery services for stroke patients, including a lack of nursing staff, medical professionals and psychologists.
It also found that 73% of hospitals were unable to provide recommended levels of therapy.
The HSE's clinical lead for stroke, Professor Joe Harbison, said the health service would probably need around 250 extra therapists for the adequate treatment of stroke.
Almost two thirds of facilities surveyed did not have a stroke specialist.
The vast majority of the hospitals also had no access to community rehab teams to continue essential therapy for patients after they are discharged home.
The audit team recommends a major investment to provide more beds, healthcare professionals, therapists and community teams to deal with the deficiencies highlighted.



Prof. Harbison said a person's chance of recovering from stroke is "dependent on the skills of the people" who are in the hospital where they being treated.
Speaking on RTÉ’s Morning Ireland, he said this may "depend a little bit on geography, on where your access to specialist rehabilitation services are".
He said these services can also be dependent on age as "a lot of the rehabilitation services in Ireland are run through elderly care services".
In the case of 50% of the units, if "you're under 50, you can't get into the unit" and he said these people are "often left waiting maybe months to get into the National Rehabilitation hospital".
Prof. Harbison said when people have had their initial treatment for stroke, they are moved onto a rehabilitation centre but that's "very often non specific for stroke".
He said there may be certain skills lacking in this centre - while they may get physiotherapy and occupational therapy, they may not get specialist therapy and are unlikely to get the duration of the therapy they need.
He added that they may not get other therapies such as psychology at all, as only one third of the hospitals have any access to psychology services.
Claiming that access to rehabilitation services and sufficient rehabilitation staff is a long-standing problem, Prof. Harbison said rehabilitation should happen in the
first 24 hours of stroke.