Rehab time for stroke ‘should be at least three hours a day’, new guidelines suggests

By Storm Newton, Reporter18th October 2023News EnglandHeart Disease, Long Term Care / Conditions, News England, NHS, NICE, Stroke

The amount of rehabilitation time offered to people who have suffered a stroke should increase four-fold, according to new guidelines, despite huge staffing pressures in the NHS.

The National Institute for Health and Care Excellence (Nice) said it recognises the challenge the health service faces in delivering on its recommendation, but the importance of rehabilitation for stroke survivors should not be underestimated.

Former Nice guidelines published in 2013 recommended initially offering 45 minutes of relevant stroke rehabilitation for a minimum of five days per week, although this could be increased depending on the preference and ability of the patient.

However, the NHS spending watchdog has now said this should be upped to “at least” three hours a day, five days a week.

The treatment should cover a range of therapies, including physiotherapy, occupational therapy and speech and language therapy.

It comes after evidence reviewed by an independent committee said more intensive rehabilitation improved quality of life in those who had suffered stroke.

According to the Stroke Association, 100,000 people in the UK have strokes every year, while about 1.3 million people are stroke survivors.

Dr Maeva May, associate director for policy and research at the charity, said: “It’s vital that governments act urgently to address staffing issues across health and social care and within rehabilitation services and share detailed plans to support and resource them, so that these recommendations can become a reality.”

Professor Jonathan Benger, chief medical officer at Nice, said the organisation recognises “the challenges the system faces in delivering these recommendations, not least the problems inherent in increasing service capacity and staff”.

He added: “We also know current practice is inconsistent, even when it comes to implementing our previous recommendations.

“But equally it shouldn’t be underestimated how important it is for people who have been left with disabilities following a stroke to be given the opportunity to benefit from the intensity and duration of rehabilitation therapies outlined in this updated guideline.

“By focusing on what matters most, we need to find ways to enable people who have had a stroke to access the level of rehabilitation that supports their recovery and meets their long-term needs and goals.”

Jon Brown, director of strategic partnerships at Barnardo’s and chairman of the guideline committee, said: “The impacts of stroke are significant and this updated guideline provides a comprehensive, current, evidence-led synthesis of best practice in stroke rehabilitation.

“The guideline committee comprised an impressive mix of clinical and lived experience and this product of the committee’s work will make a significant contribution to improving outcomes for stroke survivors.”

Dr May said stroke can have “wide-ranging impacts” and it is “vital” every survivor gets the support they need.

“Research shows that frequent and more intense rehabilitation leads to better recovery following a stroke but many stroke survivors only receive a fraction of what this guideline recommends, leaving many without support and limiting their improvement post-stroke,” she added.

“Every stroke is different and so is every recovery, so it’s important that stroke survivors can access person-centred support for as long as they need it, so they can regain their independence and rebuild their lives after stroke.”

An NHS spokesperson said: “Thanks to ongoing improvements in NHS care, more people than ever are surviving a stroke.

“Despite the current workforce and capacity pressures acknowledged by Nice, the NHS is delivering high-quality specialist support for stroke patients – including through physiotherapy, occupational therapy and speech and language therapy – closer to patients’ homes.”