Stroke Sufferers

I know from reading up for this debate and from past debates, how committed my hon. Friend is to this topic, and the effort that he has put into it over many years. I agree with him, and I will come on to say a few words about stroke clubs and the difference between them and communication support groups, which are also very important. As part of the stroke improvement programme, there is a central national team—I am pleased to say that it is based in the east midlands—which supports the development of the 29 local stroke care networks I mentioned. In Nottingham, a well-established partnership works across the local health and social care community through the stroke services strategy group with representation from the Stroke Association and an excellent relationship with @astroke, the local patients forum. There are also strong local research links with the university. Professor Marion Walker and Ossie Newell, a stroke survivor, were winners of a local media ““reach out”” award for their work in developing research and rehabilitation programmes for people who have had strokes. My next question is about rehabilitation. NICE recommended 45 minutes of rehabilitation a day. Does the Minister know when that target is likely to be met? What steps are we taking towards it? As part of the national stroke strategy, the Department of Health published a local authority circular last May entitled, ““Demonstrating how to deliver care for adults in the community.”” It stated that councils with adult social services responsibilities in England receive funding to deliver long-term stroke care for adults in the community, and it encouraged more joint working between health and social care providers. That is important to enable stroke survivors to receive a seamless transfer of care from the hospital to the community, and to ensure that they receive the support they need for as long as necessary. Does the Minister know specifically whether information about how that grant is spent by local authorities will be made public, so that we can see the implementation of the stroke strategy as it unrolls and overall monitoring can take place? The money is apparently ring-fenced, and we must ensure that it stays that way. The funding, however small, must be sustainable—I do not know how many debates in Westminster Hall I have been attended where I have said that. Quick bursts of activity for one year or for three, are often worse than useless. I would prefer to have smaller amounts of money sustained over a longer period, so that people know where that central core of money is and can build around it. Colleagues from all parties have mentioned community services. A particularly pleasing part of the new strategy are the references to the value of communication support groups for stroke survivors. The Stroke Association has pioneered work in that area with its ““Lost without words”” campaign. Communication difficulties include aphasia and speech impacts, which affect approximately one third of stroke survivors. Without support, survivors can experience problems including depression, isolation and an inability to return to work. Currently there are no communication support services in the Nottingham area. The group Aphasia Nottingham aims to help, but it is entirely voluntary and receives no statutory funding. However, there is a real need for that service in Nottingham. At present only 12 per cent. of stroke survivors in England have access to communication support groups organised by the Stroke Association. That figure is even lower in my area, which I share with my hon. Friend the Member for North-West Leicestershire. Historically, there have been challenges to the discharge of stroke survivors back into the community, thereby creating ““bed blocking.”” Nationally, a community stroke team is in place, and from January next year, there will be a system of early supported discharge, which should help to address that problem. Nottingham primary care trust is currently recruiting a team for that system. Community care for stroke survivors is fragmented. The level of care that someone receives seems to depend on the area in which they live. In Nottingham, adult social services care for stroke survivors, and a 12-week programme called Stroke Ability is heavily exercise-based and has elements of prevention and awareness work. As my hon. Friend the Member for North-West Leicestershire said, there are a number of stroke clubs in the area. From next year, a further family and carer support service in the south of the county will be funded by new local authority funding to help people with the transition from hospital to home. It is imperative that the Government encourage local authorities and PCTs to take account of the communication support needs of stroke survivors in their communities, and ensure that they keep that money ring-fenced for stroke-specific services. Finally, the national sentinel audit of stroke care by the Royal College of Physicians has proved an extremely useful tool for monitoring the implementation of standards and service improvements in the acute sector. However, there has not been a similar focus on monitoring community services. The Healthcare Commission's patient survey 12 months after discharge from hospital was published in 2006, and gave an excellent snapshot of the standard of care and support for stroke survivors in the community. For my 13th question—there is just one more before I sit down—may I ask the Minister whether further surveys along those lines or an extension of the Royal College of Physicians auditing process into community care will be undertaken? My final and briefest question is about the development of the work force to meet the markers that the Secretary of State mentioned when announcing the strategy. In Nottingham, we have a stroke training programme for all staff working for the stroke service, and we have one of the 10 Government-funded medical stroke specialist training posts. However, although the funding is welcome, again it is non-recurrent. We need specialist staff with stroke knowledge and skills, and Department of Health training for an agreed competency framework. When will that framework be ready and how will it be managed? Will units receive accreditation for providing different levels of specialist care? How much sustainable support are the Government providing to all levels of stroke care staffing? I hope that I have been generous in accepting interventions to allow a large number of colleagues to contribute, and I apologise for taking up a lot of time. I believe that the Government are to be congratulated heartily on putting in place an excellent, although long overdue, stroke strategy. People who care about this subject, from all parties, inside and outside this House, campaigned for it for a long time. We must now put stroke awareness high on the agenda and ensure timely and urgent treatment to improve the quality of life of people suffering the after-effects of a stroke. I hope that this debate gives the Minister an opportunity to tell us what progress has been made since the national strategy was announced and what milestones he hopes can be achieved over the next year. The key message that I have received in putting together this debate is that it is not so much about money, but about organisation. As with so much public policy, if we choose to intervene early, the impacts will be cheaper, more effective and, in this instance, will save many lost and broken lives. I thank you, Mr. Williams, for allowing me to make my case at some length.