Section 1 - Cardiovascular Disease Services
Coronary Heart Disease Team
The Coronary Heart Disease Nursing Team was initially set up during 2001 within the Cheltenham and Tewkesbury PCT area. The role incorporates the education, support and treatment of patients/carers and will advance the education of multi-disciplinary professionals by acting as an expert resource on issues relating to CHD.
The aims of the service are to:
- To facilitate the implementation of the National Service Framework for CHD, new developments and research recommendations in primary care
- To improve communication between primary care, secondary care and the primary care trust.
- To implement educational strategies to support patients and clinicians
- To improve patients understanding of their condition
The team consists of coronary heart disease nurses who are responsible for offering domiciliary follow-up, which includes phase II cardiac rehabilitation, to all patients post myocardial infarction. More recently patients post coronary artery bypass will also be offered a follow-up visit. The team have set-up clinics within each GP surgery that are now run by practice nurses so that patients receive an annual review of their cardiovascular disease.
Angina Plan The angina plan is a programme of 3 sessions running over a course of 8 weeks. It is for people registered with a GP in Cheltenham or Tewkesbury who have recently been diagnosed with angina. The programme is run by CHD nurses and is based at the Prestbury Centre in Cheltenham. The programme will answer questions like...
- What causes angina?
- How will it affect my life?
- How will it affect my future?
- What will make it better?
- What will make it worse?
Heart Failure Service
The Heart Failure Service was initially set up during 2003 for patients with heart failure in Gloucestershire. The nurses work in a countywide team but carry their own caseload of patients. They are responsible for the management of patients with new presentations of heart failure that are diagnosed through the community based 'Heart Function Clinic'. More recently further nurses have been added to the team, utilising funding through the British Heart Foundation. These nurses manage patients following discharge from hospital for unplanned admissions with heart failure and ultimately will also cover patients known to have heart failure within the community, as appropriate. The role incorporates the education, support and treatment of patients/carers and will advance the education of multi-disciplinary professionals by acting as an expert resource on issues relating to heart failure.
Community Stroke Services
Co-ordinator
The role, developed in 2003, incorporates the education and support of patients/carers following stroke. It aims to advance the development of patient centred services through working in partnership with both community and hospital based multi-disciplinary professionals.
Prestbury Centre
Provides interdisciplinary neurological therapy services including Speech and Language Therapy, Occupational Therapy and Physiotherapy. The service, initially aimed at people following stroke, is designed to be person-centred and built around the goals of the patient and their carer. Service users have the advantage of being able to see therapists from different disciplines at the same time, working towards shared goals, enabling a holistic approach to people's rehabilitation. Referral to this service is through a health care professional.
Life after Stroke Programme
A seven week, goal orientated programme for people who have had a stroke and their relatives/carers aimed at the secondary prevention of stroke. Through supporting lifestyle change to reduce individual risk factors service users and their carers are empowered to make informed decisions to maximise their quality of life. The programme includes: risk factors for stroke; medication; physical implications etc. and runs from the Prestbury Centre and the Assessment and Rehabilitation Unit at Tewkesbury Hospital. Referral to this service is through a health professional.
Tewkesbury Hospital Assessment & Rehabilitation Unit
The unit, acts as either a stepping-stone between hospital care and community care or works alongside community care. It provides flexible individual multi-disciplinary assessment with an action plan for people who require rehabilitation. After individual assessment the services provided include Occupational Therapy, Physiotherapy, Medical and Nursing.
Section 2 - Resources/Guidelines
To be compiled
Section 3 - Reports
To be compiled
