Objective: Major improvement has
been made in the medical management of stroke in the UK between 2008 and 2010
based on the indicators measured in the National Sentinel Audit. However
based on the same audit, no corresponding improvement has been effected to patient
functional impairment levels on hospital discharge in the corresponding time
frame. This study derived patient-to-therapist ratios as a means of exploring
the amount of rehabilitation time for stroke patients while in hospital care. Method: A purpose specific survey
was developed for completion by stroke teams. From a contact list compiled
primarily in collaboration with the 28 National Stroke Improvement Networks,
the Nth name technique was
used to target stroke teams in each geographical area covered by the 28
networks. Results: A total of 53 surveys were
returned representing 20 of the 28 network areas providing 71% national
coverage. Analysis conducted on 19 of the 37 inpatient hospital care units
that were discrete units, had no missing data for staff numbers, unit bed numbers,
number of stroke patients treated per annum, average unit length-of-stay,
and unit occupancy rates. Staffing levels for some therapies were below the
Department of Health staffing assumptions suggesting that stroke units are
challenged to provide the recommended therapy time. Conclusions: Most stroke
units surveyed are operating below the DH staffing assumption levels and are
therefore challenged in providing the amount of therapy and patient time recommended in the National Institute of Clinical Excellence guidelines to
facilitate optimal functional recovery for stroke patients.
 National Stroke Association (2012) Stroke fact sheet.
 National Audit Office (2010) Department of Health: Progress in improving stroke care.
 Kong, K.-H., Chua, K.S.G. and Lee, J. (2011) Recovery of upper limb dexterity in patients more than 1 year after stroke: Frequency, clinical correlates and predictors. NeuroRehabilitation, 28, 105-111.
 (2007) National stroke strategy.
 Royal College of Physicians (2011) National sentinel stroke clinical audit 2010 round 7. RCP, London.
 Royal College of Physicians (2007) National Sentinel stroke audit—Organisational audit, 2006. RCP, London.
 (2013) Royal Geographical Society. Sampling techniques.
 Dillman, D.A. (1978) Mail and telephone surveys: The total design method. Wiley-Interscience, New York.
 Venkataraman, L. and Zurawski, E. (2007) Can the Dillman Method be applied to e-mail prompting with a twenty-something population. The American Association for Public Opinion Research (AAPOR) 62nd Annual Conference.
 Department of Health (2009) NHS workforce planning resource. http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/
 National Institute of Clinical Excellence (2012) Rehabilitation after critical illness: NICE clinical guideline.
 National Audit Office (2010) The prevention, management and control of healthcare related infections (HCAI) in hospitals (ROCR-LITE/08/014/FT6).
 Royal College of Surgeons (2010) High NHS hospital bed occupancy remains a big infection risk.
 Putman, K., DeWit, L., Schupp, W., Ilse, B., Berman, P., Connell, L., Dejaeger, E., DeMeyer, A.M., DeWeerdt, W., Feys, H., Walter, J., Lincoln, N., Louckx, F., Martens, A., Schuback, B., Smith, B. and Leys, M. (2006) Use of time by physiotherapists and occupational therapists in a stroke rehabilitation unit: A comparison between four European rehabilitation centres. Disability and Rehabilitation, 28, 1417-1424. doi:10.1080/09638280600638216
 Pring, T., Flood, E., Dodd, B. and Joffe, V. (2012) The working practices and clinical experiences of paediatric speech and language therapists: A national UK survey. International Journal of Language & Communication Disorders, 47, 696-708.
 Department of Health & Royal College of Physicians (2007) Survey of stroke unit staffing and patient dependency. DH, London.
 DeWit, L., Putman, K., Dejaeger, E., Baert, I., Berman, P., Bogaerts, K., Brinkmann, N., Connell, L., Feys, H., Jenni, W., Kaske, C., Lesaffre, E., Leys, M., Lincoln, N., Louckx, F., Schuback, B., Schupp, W., Smith, B. and DeWeerdt, W. (2005) Use of time by stroke patients: A comparison of four European rehabilitation centres. Stroke, 36, 1977-1983. doi:10.1161/01.STR.0000177871.59003.e3
 Kwakkel, G., van Peppen, R., Wagenaar, R.C., Dauphinee, S.W., Richards, C., Ashburn, A., Miller, K., Lincoln, N., Partridge, C., Wellwood, I. and Langhorne, P. (2004) Effects of augmented exercise therapy time after stroke. A Meta-Analysis. Stroke, 35, 2529-2536.
 Turton, A. and Pomeroy, V. (2002) When should upper limb function be trained after stroke? Evidence for and against early intervention. NeuroRehabilitation, 17, 215- 224.
 Rudd, A.G., Jenkinson, D., Grant, RL. and Hoffman, A. (2009) Staffing levels and patient dependence in English stroke units. Clinical Medicine, 9, 110-115.
 Intercollegiate Stroke Working Party (2012) National clinical guideline for stroke. 4th Edition, RCP, London.