India's first ever stroke unit looks set to become a reality thanks to the specialists from an acute hospital Trust on the London - Surrey borders.
Stroke Unit Sister Usha Sagoo and clinical specialist in stroke rehabilitation, physiotherapist Michelle Green of the Ashford and St. Peter's Hospitals NHS Trust have returned from India, where they have been passing on their stroke care expertise.
Their trip followed a visit a few weeks earlier to the Apollo Hospital, Ludhiana, by Ashford and St. Peter's Hospitals NHS Trust colleague, Consultant Physician Dr Bhaskar Mandal who had been asked for advice following the illness of a Sikh religious leader, His Holiness Satguru Ji, the leader of the Namdhari Sikh Vidyak Jatha, in the Punjab.
Being able to put the palms of your hands together is a very important movement in the Sikh community. Stroke rehabilitation Physiotherapist Michelle Green is pictured here teaching a patient arm exercises which enabled him to achieve the movement by the end of the session.
Said Dr Mandal: "Stroke is the third largest killer in the world. Fast access to treatment and concentrated rehabilitation can make a huge difference to the outcome for a patient. We are very proud of what our team are achieving in our stroke unit and our stroke team have been involved in spreading information about stroke to the community around the area served by Ashford and St. Peter's Hospitals. I've given talks on stroke management at Sikh temples in the Southall area of London, which is how we came to be approached to go to India."
The Ashford and St. Peter's Hospitals NHS Trust team have now been asked to advise on setting up not only the first stroke rehabilitation unit in the Punjab, but the first such unit in the whole of India. Dr Mandal will be returning in a few weeks time and by the late autumn the Apollo Hospital may be ready to open a 12-15 bed stroke rehabilitation unit.
Said Dr Mandal: "They have brilliant physicians, but the next step is rehabilitation. What is lacking out there is the team approach. Usha and Michelle have taken the expertise from here and shown them what they have never had on their wards. We know that 48 hours after a stroke the nursing and therapy in-put becomes equally important to the medical treatment. They are keen for us to share our expertise and it is a two-way process - we have learnt how to provide the best care with limited resources and we have learnt about family support, as care out there is not always medically and therapy-led."
Sister Usha was amazed to find around 50 people turning up for each teaching session. Usha and Michelle spent their first day on the medical ward, seeing how it was run. The doctors were predominately men. Patients do not have one consultant the whole time and so need to keep their own notes with them, including taking them home from hospital appointments.
She said: "We found that everyone was really, really interested in what we were doing. We found the doctors are pro-active but they are not used to the nurses using their initiative! We had to encourage the nurses to speak up - the culture is so different."
During their visit Usha and Michelle found that the hospital's stroke team have a good basic knowledge of stroke care. But, unfortunately, patients are often spending four or five days in the community following their stroke, before they are brought to the hospital and some are never taken to hospital.
The 350 bed Apollo Hospital has very few therapists and Usha and Michelle spent time teaching different groups each day including doctors, nurses, the hospital's three physiotherapists and occupational and speech therapists, giving them the Ashford and St. Peter's Hospitals NHS Trust "best practice" approach to patient care. Here patients may spend five or six weeks on the Trust's rehabilitation ward, but there is no rehabilitation ward yet at the Apollo Hospital
Said Michelle: "This has been a once in a lifetime experience. The care they receive on the general medical ward is quite good, but improving how they work together as a team is really important. We feel very privileged to be able to have been invited to tell them how we work in the NHS and particularly at Ashford and St. Peter's Hospitals NHS Trust.
"We had very positive feed-back from everyone and they may send two staff over here in the early autumn to see what we do here."
The response of the Sikh community in England has been sincerely appreciative of the support provided for his Holiness Satguru Ji by the Ashford and St. Peter's Hospitals NHS Trust and Dr Mandal will be speaking at Sikh Temples in the London area over the coming weeks.
Said Dr Mandal: "Their appreciation of Sikh community is enough, but we have been very grateful to learn that they are going to adopt Chaucer Ward and the Trust's stroke service as their preferred charity for the coming year. This is a very generous gift that will benefit patients, their carers and the dedicated work of our staff and is very much appreciated."