The Suffolk stroke early supported discharge service brings together hospital staff, stroke-specialist therapists and rehabilitation assistants, and voluntary organisations to work together with patients and their carers.
Our stroke early supported discharge team helps people recover after a stroke, by providing care and rehabilitation in their own homes across Suffolk.
We work with patients to set personal goals and create a plan that meets their needs. This support can include physiotherapy, occupational therapy and speech and language therapy, depending on what each person needs to get better.
We also give stroke education and training to patients and their carers. This helps people understand their stroke and learn how to manage at home. We also share our knowledge with other health and care staff.
Types of therapy we offer
Physiotherapists help you move better and get your strength back. We look at how your stroke has affected your muscles, balance and walking. We help you practise things like getting up and down stairs, standing up safely and moving around your home. We use exercises to help your brain and body learn new ways to move. This can help you return to the activities you enjoyed before your stroke. We build a plan that fits your goals and work with you to reach them step by step.
Occupational therapists help you do everyday things that may be harder after a stroke. This can include getting dressed, washing, cooking, hobbies or going back to work. We see what you can do and what you find hard, then help you find new ways to do tasks safely. We might give you equipment to make things easier. We also set goals and practice skills together, with help from our rehab assistants. We work closely with you and your family so you can stay as independent as possible.
Speech and language therapists help you if your stroke makes it hard to speak, understand others or swallow food and drink. We check what help you need and work with you to make a plan. This might include exercises, using pictures or writing, or learning new ways to communicate. We also help your family understand how to support you to join in conversations. If you have problems with swallowing, we help you find safe ways to eat and drink so you stay healthy.
Our psychologist supports your feelings and mental health after a stroke. Having a stroke can be a shock and bring worries about the future. You might feel sad, worried or frustrated. We can help you and your family talk about these feelings and learn ways to cope. We check for signs of anxiety or depression and help you find support if you need it. We can see you at home to listen and give advice that fits your needs, so you feel more able to move forward with your recovery.
Our team works closely with local NHS and social care services to make sure patients get the right care and support.
The service is run by a group of organisations working together, including:
West Suffolk NHS Foundation Trust
East Suffolk and North Essex NHS Foundation Trust
Suffolk County Council
Local charities and voluntary groups
Our goal is to help people recover safely and regain their independence after leaving hospital.
Contact the team
The service runs from 9am until 5pm, Monday to Friday. We do not provide a weekend, bank holiday or overnight service. You can call us on 0345 5045421 or email suffolkesd.referrals@nhs.net
If you need support out of hours, please use other NHS services, including NHS 111 and your GP out of hours service. In an emergency, always call 999 for urgent help.
Where to find us
There are two bases: one in Bury St Edmunds and another in Ipswich, but generally the team will be with patients in the community, supporting them you in your own home.
Frequently asked questions (FAQs)
The service receives referrals from hospital stroke services, including West Suffolk Hospital and Ipswich Hospital.
Not all stroke patients are eligible. We take patients who have had an ‘acute’ stroke. Our team works closely with hospital stroke services to identify those patients who would most benefit from our service. To be eligible for this service, it is essential that you are safe within your home environment, with or without a carer present, and you are able to cope with an intensive programme of rehabilitation for up to six weeks.
Once you are home, we will provide therapy, treatment, care or advice, as needed, to improve your recovery and independence after a stroke. This is an intensive service for up to six weeks, which provides individualised therapy programmes that reflect the your own personal goals, which we will help you set. The team provides a patient-centred service that also includes carers, friends, and loved ones where appropriate. The service includes therapeutic interventions, stroke education and training to promote independence and longer term self-management.
Our service provides interventions with individual patients for up to six weeks. You may be discharged earlier, as your rehabilitation programme is created with you and reflects your personal goals and clinical needs. At the end of the programme we may refer you on to other local services to help you continue in your recovery. We’ll discuss this with you as part of discharge planning from our service.
Our main aim is for you have achieved your agreed rehabilitation goals, and be on a good recovery path. If you still need support after your initial rehabilitation, we will put you in touch with appropriate services to support you.
