NHS failing stroke patients with 'postcode lottery rehabilitation'

Denis Campbell Health policy editor
Photograph: Wavebreakmedia/Alamy

Patients are failing to recover properly from a stroke or heart attack because the NHS offers too little rehabilitation for people discharged from hospitals, a report has warned.

“Patchy provision” means those with arthritis, multiple sclerosis and other long-term conditions also miss out on care that can make a huge difference to their health and quality of life, according to the report from the Chartered Society of Physiotherapists (CSP), Royal College of Occupational Therapists and the charity Sue Ryder.

The report detailed a “postcode lottery” in the availability of community rehabilitation in England, which is having “devastating consequences” for patients who have just been treated in hospital or have recently been diagnosed with a serious illness, including cancer.

Shortages and long delays in the quest for help are leaving many feeling abandoned by the NHS at a time when they need help to get their lives back on track, the report said.

Rehabilitation often involves physiotherapy to improve people’s mobility. Karen Middleton, the CSP’s chief executive, said: “Everyone should get the rehab they need to live life to the full and be as independent as possible. It’s not acceptable that we are missing opportunities to improve lives.”

In a survey of 1,002 people who have a long-term health condition, just 29% said they had received enough rehabilitation. Those who miss out are more likely to suffer continuing ill-health, fail to get back to work and incur avoidable care costs to the NHS.

The report also said:

  • Only 15% of those with lung problems deemed eligible for pulmonary rehabilitation are referred for it.

  • Just 50% of people who have had a heart attack or stroke have cardiac rehabilitation after being discharged.

  • Most cancer patients do not receive rehabilitation before they have treatment, even though that can boost the chances of success.

Among the 71% of patients who felt they received too little rehabilitation, 44% said they felt “abandoned by the system” as their needs went unmet.

The report cited the experience of Elizabeth Printer, a judge and mother of two whose life fell apart when she suffered a brain haemorrhage aged 46. She ended up paying for private rehabilitation to help her learn to walk again after waiting seven months for NHS community rehabilitation.

“The NHS saved my life in an emergency but then failed to help me recover any of the life I once had,” said Printer, who is now 48. “I had to teach myself to walk again. I wanted to get well for my daughters but there was no support or guidance about how I could do this.

“I just needed to have the right rehab, treatment, and love and care, but it was never there,” she added.

Printer had to retire from her job, her marriage broke down and she suffers from pain and depression.

NHS England has pledged to greatly expand access to care outside hospitals as part of its long-term plan. But the bodies behind the report claimed NHS bosses are breaching the health service’s own constitution by not ensuring that rehabilitation is available everywhere, because it stipulates that care must be comprehensive.

“There are thousands of stroke survivors being let down by the health and social care system when they leave hospital because of a postcode lottery for physiotherapy and rehabilitation services that desperately needs fixing,” said Charlotte Nicholls, head of policy at the Stroke Association.

“We hear stories of stroke survivors who were told they would never walk, feed themselves or hold a pencil again being able to do all of these things after sustained rehabilitation and hard work from teams of specialists. These life-improving gains are being denied to people who cannot access rehabilitation services,” she added.

A spokesperson for the NHS said: “Amongst the 26,000 more primary care staff will be physios and musculoskeletal teams to help people get back on their feet as quickly and safely as possible. The NHS long-term plan will also see most patients attending cardiac rehabilitation services, with rehab for stroke more easily accessible through integrated stroke centres.”