Increasing Intensity & Frequency of Rehabilitation

The network is working to support Greater Manchester’s stroke and neurorehabilitation teams in delivering higher intensity, higher frequency rehabilitation aligned with the latest clinical guidelines and patient-centred care models.

Why this matters

The 2023 National Clinical Guideline for Stroke recommends that patients with motor recovery goals receive a minimum of 3 hours of multidisciplinary therapy per day, at least 5 days a week . However, many services across Greater Manchester face challenges in meeting this standard due to resource constraints, underutilisation of digital health technologies (DHTs), and limited access to community services.

Without sufficient intensity and frequency of rehabilitation, patients may experience prolonged recovery times, increased dependency, and reduced quality of life. This can also lead to higher social care needs and increased demand on primary and secondary healthcare services.

The network are working closely with stroke and neuro rehabilitation teams on initiatives that fall under the following workstreams:

1. Digital Health Technologies (DHTs)

Funding and Procurement: Identify and share funding opportunities for DHTs.
Case Studies: Collate examples of successful DHT implementation in rehabilitation settings.
Patient Engagement: Explore how DHTs can support patient self-management and adherence to rehabilitation programs

2. Workforce Optimisation

Group and Semi-Supervised Rehabilitation: Develop guidelines and share best practices for implementing group sessions and semi-supervised activities.
Training: Provide training for staff to effectively deliver these models of care.

3. Accessing Community Services

Partnerships: Strengthen links between rehabilitation teams and community resources such as gyms, leisure centres, and voluntary sector providers.
Training for Community Staff: Identify training needs and facilitate education for non-specialist staff in community settings.
Service Integration: Develop pathways for patients to access community services as part of their rehabilitation program.

4. Patient Self-Management

Tools and Strategies: Identify and share effective tools and strategies to assist patients in managing their rehabilitation independently or with support from family and carers.
Best Practice Guidelines: Develop guidelines for clinicians to support patient self-management.

Digital health and technology

Increasingly, digital technology such as smartphone apps and virtual reality are being used to help patients prevent, manage and recover from long term health conditions.

Since the pandemic, teams are now working more remotely, which has required the implementation of virtual consultation and rehabilitation.

It is essential that healthcare professionals select and utilise digital technology appropriately, ideally using evidenced based products that have been endorsed by the NHS or a similar body. A product must be beneficial to its user, and should also comply with UK information governance requirements, with cost and accessibility other important considerations.

Digital health technology can be used to help patients and their carers in the following ways:

Stimuli for skilled and functional therapy
Home practice
Assessment
CVD prevention and healthier lifestyles
Emotional well-being
Education
Social engagement and peer support

The NHS app library has now been closed and appropriate apps are now recommended through the NHS website which can help inform professionals and the public, with other organisations such as ORCHA providing searches for rated apps with a site set up for physiotherapy for CSP members. Aphasia software finder is an up to date website that can be used to find products relating to the condition.

Healthcare professional bodies may have codes of conduct for using technology, as may local NHS Trusts and these should be followed by clinicians.