Changes in practice

Integrated Stroke Service in Newham

Speech and Language Therapist Mary Pointer has been aware of Connect and the Connect ethos of involving people with aphasia in service development and access since her student days. Mary and her team in Newham chose to train with Connect as it was one of the few places that offered training to whole teams rather than just individuals.

What made the difference

With the help of Connect and their specialist training, we embarked on a project that we called the 'Better Conversation Trainers Project – Making Stroke Connections'.

The first part of the project involved training volunteers with aphasia to assist in the provision of “Better Conversation” training sessions for staff working with people living with aphasia or stroke related communication difficulties. Nine people with aphasia were invited to participate in the project and Sally McVicker, Innovations Project Manager, from Connect led a two-day training session for the volunteers with aphasia.  I supported the training session in addition to a volunteer from our service.

The volunteers with aphasia who were trained during this first part of the project were then involved in training staff members in the second part of the project.  Part two of the project involved two training sessions – one with the stroke unit staff including physiotherapists, nursing staff, occupational therapist and another with the unit's junior doctors.

The training sessions were divided into two parts. A brief teaching session led by the speech therapist covering the basics of good/bad conversations was followed by a practical session.  In the practical session each of the volunteers with aphasia who were trained earlier became the trainers and spent 15 minutes having a conversation with one of the delegates. After the conversation the trainers gave the delegates feedback using a structured rating sheet.  The session with the junior doctors followed a similar format. 

Feedback

Overall the training was really well received by both people with aphasia and staff members.

John Miles, an independent consultant involved with the project, remarked that 'by treating the trainees with aphasia primarily as capable people, Connect offered them a very empowering experience – the approach provided inspiration and security'.

Feedback from the training sessions with the stroke unit staff was also extremely positive.

'Feedback from patients during interviews was very useful…so I can adapt my response in future'

'Refreshing!'

'There was a real buzz after the session from the trainers…they're all really excited and look forward to doing it again soon'

The doctors that took part remarked that 'meeting and speaking to a stroke patient gave a real insight into the realities of the problems stroke patients face' and that 'talking to a patient and seeing their perspective of speech difficulty was useful'.

Outcomes

Following the project, we have made some key changes to the service. There is better recognition and awareness of aphasia e.g. the stroke unit now has copy of The Stroke and Aphasia handbook at each bedside. Trainers with aphasia are now involved in regular training sessions for doctors and we're attempting to establish a network of the fifty people trained in Better Conversations to maximise benefits across the community. We are also about to launch a local Stroke Service handbook/leaflet which has aphasia friendly elements. An added bonus for us is that the improvements in our service are in agreement with the guidelines suggested in the Life After Stroke section of the National Stroke Strategy.

What next?

We hope that in the future there will be more opportunities for people with aphasia to be involved in service development issues and more regular training sessions run with trainers as well as ongoing recruitment of trainers. There will always be challenges such as time, money and administrative support but hopefully with commitment and persuasion we will continue to build relationships and maintain awareness of communication across hospital and community settings.  

Sally McVicker with people with aphasia in Newham, who are training to become conversation partners

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