RCSLT Stroke Unit Survey Results

RCSLT stroke unit survey results

As many of you will know, the RCSLT is working with the Department of Health (DH) on the development of its national stroke strategy, planning future speech and language therapy services for stroke patients.

At the end of 2006, the DH approached the RCSLT to identify examples of best practice in stroke units including staffing ratios and length of stay.

In response, the RCSLT surveyed nine speech and language therapy stroke services to highlight models of best practice in acute and community stroke units.

Seven units responded to the questionnaire, which consisted of 59 questions to analyse the demography of their area, average activity data – including staffing numbers, length of stay, number of beds and patient contact times. It also compared data across units and between inpatient and outpatient community services.

Key points from the survey

Inpatient services:

• Half of the units rarely offer inpatient intensive therapy
• Half offer training to nurses and others in communication and swallowing
• Half of the SLTs attend multidisciplinary handover meetings and all surveyed attend weekly multidisciplinary meetings
• No SLTs had a weekly time allocation for research. This contradicts good practice, which states that SLTs should have dedicated time to research

Notional caseloads for inpatients per whole time equivalent (WTE):

• On units with separate acute and rehabilitation beds, there on average 21 beds per WTE inpatient in acute settings and 27 beds per WTE in rehabilitation
• On units of mixed acute and rehabilitation beds, the average number of beds per WTE inpatient was 14

Outpatient/community services:

• Half the units provide a service to the family or carer during the transition from hospital to community services
• Over half highlighted that if they had the resources to design the transition from hospital to community they would introduce more conversation groups and ensure a seamless service
• A third of unitsnever offer intensive therapy to outpatients; a third rarely offer intensive therapy
• A third of units offer general training to nurses and others in communication. Half offer training to nursing homes and others in dysphagia.
• Half of SLTs do not attend multidisciplinary meetings
• Over half of SLTs would like to see their outpatients more frequently to improve their service. Half would like to increase their multidisciplinary/interdisciplinary stroke working and two units were concerned that they are currently not part of the recognised community stroke team

The SLTs are currently involved with the following stroke policy groups:

• The National Institute for Health and Clinical Excellence guideline development group for the diagnosis and acute management of stroke and transient ischaemic attacks
• DH National Stroke Strategy – the workforce, acute stroke care and post-hospital stroke care expert project groups
• The Royal College of Physicians Intercollegiate Working Party for Stroke
• The Connecting for HealthStroke Expert Reference Group Pathway
• The Skills for Health Stroke Strategy Group

The RCSLT has established a stroke e-group to bring together SLTs who have an interest and to share information and best practice. To join, send an email with your details to:

For further details or a copy of the stroke unit survey results, email:

Claire Moser

RCSLT Policy Officer

Acknowledgements:

The RCSLT thanks the seven participating stroke units for their assistance: Kim Clarke, Northwick Park Hospital; Rosemary Cunningham, Derbyshire Royal Infirmary; Debby Rossister, King's College Hospital NHS Trust; Laura O'Shea, Salford Royal Foundation Trust; Claire Gatehouse, Plymouth Teaching PCT; Stef Ticehurst, North Bristol NHS Trust; Julie Morris, The North East Aphasia Centre.