What is the impact of large scale implementation of early support discharge?

East Midlands
Start Date: 1 Oct 2017 End Date: 1 Oct 2020

Early Supported Discharge (ESD) is the discharge of a stroke patient from hospital to their own home, co-ordinated by a team of therapists, nurses and a doctor. Specialist stroke rehabilitation is then provided in the patient’s own home. Clinical trials have shown that patients who received ESD spent less time in hospital and recovered better, than patients who didn’t.

A variety of ESD services have now been set up across England. Do these services offer the same benefits to patients as those identified in clinical trials? This research programme will try to answer this question.

Study 1 will use data that has been routinely collected by hospital and community services across the North, Midlands and East Anglia regions of England. It will compare the length of hospital stay before and after the introduction of the ESD service in each region, to see if there has been a change.

It will also look at how many patients use ESD and how much rehabilitation is provided at each site, and whether this affects how patients recover. The study will compare different models of ESD across the North, Midlands and East Anglia regions to try and understand if some are better than others.

Study 2 will involve interviewing NHS staff to gain a deeper understanding of how ESD services are operating in practice and what factors influence the effectiveness of the service. Stroke survivors and their families will also be asked about the ESD service they used, what they hoped to gain from experiencing this type of service and what matters to them most.

Research findings will drive improvements in stroke services across England and internationally, leading to provision of more efficient, evidence based care and better patient recovery.


Dr Rebecca Fisher