Each year in the UK, more than 100,000 people will have a stroke – that’s one person every five minutes.
When someone has a stroke, part of the blood supply to the brain is cut off, which kills brain cells. Any damage to the brain can affect how the body works, and it can also change how someone thinks and feels. The effects and long-term impact of a stroke depend on where it takes place in the brain, and how big the damaged area is.
Though a stroke affects people in different ways, rehabilitation is a vital part of every stroke survivor’s journey, starting from a patient’s arrival to hospital and continuing in the community then at home.
Throughout this period, a patient will be cared for by a number of therapists specialising in stroke who assess the effects the stroke has had and support the patient’s ongoing recovery needs. There is no uniform pattern of recovery for the 1.3 million stroke survivors in the UK. Their recovery journeys will vary depending on individual needs and goals, with rehabilitation playing a key role in reducing the impact of disability and enabling the survivors to regain abilities they previously had.
In this article, we look at a patient’s road to recovery through rehabilitation. From their initial arrival on the Stroke Unit at Maidstone Hospital to returning home, we follow the amazing work of our stroke therapists as they help patients achieve the best recovery possible and re-learn skills for everyday life.
Arriving at Maidstone Hospital
The dedicated Stroke Assessment Bay at Maidstone Hospital is where 90% of suspected stroke admissions are directly brought in by the South East Coast Ambulance Service. The Stroke Assessment Bay is part of the wider Stroke Unit, which cares for over 1,000 patients each year and is in the top 15% of best performing stroke units in the UK.
Advanced Speech and Language Therapist, Kirsty Waterman, who works as part of the multidisciplinary team (MDT) in the Stroke Assessment Bay, explained:
“The Stroke Assessment Bay plays a key role in identifying patients who require specific advice and therapy support for their symptoms. On arrival, the stroke assessors and doctors screen the patient for various symptoms. If further assessment or guidance is needed, they refer the patient to members of the Therapies team, as appropriate.
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“Our role as part of the MDT in the Stroke Assessment Bay is to contribute to the patient’s overall care plan. For mild symptoms, therapists may suggest a patient can return home with a therapy pack to continue their recovery independently. Others may require further assessment and a possible stay as an inpatient on the Acute Stroke Unit for rehabilitation.
“Without prompt therapy assessment and advice on arrival in the Stroke Assessment Bay, a patient may not be able to complete their usual activities safely. For example, they may not be able to eat and drink safely after their stroke, which could mean they are at risk of developing chest infections or choking. They may also be unaware of changes to their vision or limb movements, which could increase their risk of having a fall.
“Implementing a therapy programme straight away helps to keep each patient safe and start their stroke recovery off on the right foot.”
The importance of inpatient rehabilitation
If a patient is admitted onto the Acute Stroke Unit (ASU) for inpatient stroke care, they receive a number of different therapies. These help them regain mobility and learn new ways of doing things when necessary, giving them the tools needed to recover some of the abilities they had before their stroke. Inpatient rehabilitation is an essential bridge between acute stroke care and community/home rehabilitation.
Stroke Clinical Lead and Specialist Physiotherapist at Maidstone and Tunbridge Wells NHS Trust (MTW), Catherine Mandri, explained:
“The Therapies team work closely with the patient to set goals for their rehabilitation which will then be broken down into small manageable steps.
“A dietitian will monitor the patient to check their nutritional needs and hydration levels, while a speech and language therapist will undertake assessments including swallowing and communication. Further assessments will include mobility, continence and brain activity, with an occupational therapist and physiotherapist providing joint sessions on either the ward or in ASU’s bespoke rehabilitation room. A Day Room on the ward also provides patients with the opportunity to practice day-to-day skills with an occupational therapist, such as making a cup of tea or preparing meals in the day room kitchen.
Sixty-nine-year-old Philip Lautier has been a patient on the Acute Stroke Unit for six weeks. Speaking about the rehabilitation he has received on the ward, Philip said:
“My rehabilitation sessions started from day one and have included work on my grip and my walking. I’ve recently managed to climb stairs, which was a big goal of mine. In my mind, it’s helped me to feel like I could go home, easily step into the house, climb the stairs and walk around.
“When you first arrive in hospital, you don’t know how long recovery is going to be which makes it very difficult. But realising now that I’ll be able to go home in the near future has been really beneficial to my mental health.
“The progress I’ve made since arriving on the ward is all down to the physio staff. I’m an air conditioning engineer, which can be a very physically demanding job, especially with carrying heavy equipment. I’m now hoping I’ll be able to go back to work in the future, in a supervisory capacity.”
Continuing rehabilitation after leaving hospital
When a patient is ready to leave acute hospital care, they will be transferred to either an inpatient rehabilitation ward in the community or home, depending on their needs. A multidisciplinary team of specialist nurses, therapists, consultants and discharge supports services will assess the patient’s rehabilitation plan and individual needs-led goals with the patient and their family members or carers, as appropriate.
At MTW, a stroke survivor who is medically stable and can leave acute care may be transferred to Tonbridge Community Hospital, where they will stay for up to six weeks depending on their rehabilitation needs. Managed by Kent Community Health NHS Foundation Trust, this community hospital holds a rehabilitation inpatient unit where patients are supported by a stroke multidisciplinary team (MDT) of therapists, medics and nursing staff from MTW.
Kylie Tye, an MTW Advanced Speech and Language Therapist who works as part of the MDT at Tonbridge Community Hospital, explained:
“Being referred here for further rehabilitation offers several key benefits for a stroke patient.
“Community hospitals typically work with smaller patient groups, encouraging a more collaborative and personalised approach to therapy that includes the patient, their families and their support networks.
“The environment also provides important social opportunities for patients, who often form connections through group therapy sessions, shared meal times and recreational activities with ward staff. This helps to create an additional layer of support, promoting both emotional wellbeing and social engagement. These communal aspects of care are integral to the recovery process, with research showing that increased social interaction can significantly improve recovery outcomes, both psychologically and physically.
“Community hospitals also have strong relationships with both the acute hospital which referred the patient and other rehabilitation facilities and community teams. This network is particularly beneficial when ensuring the patient continue to receive the care they need after their stay.
“Lastly, community hospitals like Tonbridge offer continuity of care. The team is based there, which allows for ongoing monitoring and more consistent therapy support. This continuity helps the patient maintain momentum in their recovery and enables therapists to track progress over time, adjusting care plans as needed.”
Returning home with a specialist stroke rehabilitation service
When a stroke survivor is ready to return home, the MTW Therapies team will ensure that the patient has a safe and enabling home environment to go back to. For example, they will check that the patient’s home or care setting has the necessary equipment, and that any adaptations have been made.
Once a patient returns home, their rehabilitation will continue for up to six weeks. The Hilton Stroke Pathway, an innovative collaboration between MTW and Hilton Nursing Partners (HNP), provides home-based stroke specialist rehabilitation.
Sam Payne, Team Lead Neurological Physiotherapist for the pathway at MTW, explained:
“HNP have specially trained stroke carers who work with MTW therapists to provide varying intensity levels of care and rehabilitation. This joint rehabilitation and social care model enables a patient to safely work towards their recovery goals from the comfort of their own home.”
Seventy-one-year-old Peter Johnson is one of many patients who has recently benefited from this ongoing care. Having had a stroke in July 2024, Peter was an inpatient on the Acute Stroke Unit before being referred to Tonbridge Community Hospital for rehabilitation. He was then transferred onto this pathway to receive therapy at home. Speaking about his experience, Peter said:
“I have been having four visits a day but am now going down to three. We do hand exercises and leg exercises, including wiggling my toes, all of which have done me a lot of good and are helping me to move better.
“The staff are all brilliant, I’ve really bonded with them. One of them is also called Peter, and he likes mechanics and motors just like I used to years ago, so we talk about that a lot.
“My goal at the moment is to be able to walk to the car so I can get out and about again with my daughter. Being at home means I can do things I like, such as watching country and western films! It also means I get to see more of my grandchildren, as I really enjoy spending time with them.”
The path to recovery
From the start of their rehabilitation journey on the Stroke Unit to the end of their therapy at home or in their care setting, the support MTW’s therapists gives to stroke survivors is vast and far reaching.
Each member of the Therapies team plays a huge part in a patient’s physical and psychological recovery, supporting them to regain independence and helping them at each step of the way to rebuild their life after stroke.
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