London stroke model: acute care is not the whole picture

摘要

The reconfiguration of stroke services in London resulted in significantly reduced risk adjusted mortality and reduced length of stay in the first 21 months. An important aspect of this achievement was the increased use of community services, especially early supported discharge (ESD). Although these results are encouraging, fouryears afterthe reconfiguration there has been only limited improvement in the services commissioned to support life after stroke. Despite the importance of services aimed at maximising independence and achieving a good quality of life, there are still serious gaps in the provision of ESD, community rehabilitation teams with stroke specific skills, psychological and emotional support, and six month reviews.