National partnerships: Bradford

Lead: Professor Associate John Young

Areas of Research Interest

• Evaluation of community rehabilitation services
• Development and evaluation of the stroke services
• Evaluation of stroke rehabilitation techniques

Bradford lies immediately to the East of the Pennines in West Yorkshire. The boundaries of Bradford Metropolitan Council encompass an area of approximately 30 square miles which includes the smaller towns of Shipley and Keighley and several semi-rural and rural villages. The estimated population is 466,800 with a diverse multi-cultural mix (Middle Eastern European and South Asian), reflecting the history of the local textile industry and its attendant workforce needs.

European infrastructure grants and government initiatives are gradually impacting on economic, social and health disadvantages. The inner city has recently received Health Action Zone status to enhance the quality and scope of community health and social services. Health and socio-economic indicators for several electoral wards (mostly inner city) remain amongst the worst in the UK.

Health Care

Primary health care is organised into four Primary Care Trusts (PCTs) and there are three health trusts: Airedale Trust (combined acute and community); Bradford Hospitals Trust; and Bradford Community Trust. The Bradford Hospitals NHS Trust comprises two hospitals (St Luke's and Royal Infirmary) and has a well established Elderly Care Department with nine consultants who lead sub-specialty interests including falls, stroke, nutrition/gastro, orthopaedics and psychiatry liaison. There is considerable departmental involvement in community hospital working.

Examples of Research Work

1. Community Rehabilitation

• Randomised trial to compare day hospital attendance and home physiotherapy for stroke aftercare
• Randomised trial to evaluate specialised nurse visits to stroke patients.
• Randomised trial to evaluate home physiotherapy for patients one year post-stroke
• Systematic Review and meta-analysis of day hospital care for older people (Cochrane Review)
• Prospective evaluation of intermediate care services for older people in Leeds (collaborative project with Leeds Health Care and the Nuffield Institute for Health, Leeds University)
• Single centre, and multi-centre, trial of community hospital care for older people.

2. Stroke Care

• Acute stroke guidelines for junior doctors
• Information provision and education for patients and carers post stroke
  
• Development of Stroke Recovery programme (education rehabilitation model)
  - Randomised trial to evaluate stroke recovery programme
  - Cochrane review of information provision to stroke patients
  - Recovery profiles of stroke sub-types
  - Randomised trial to evaluate the Oswestry Standing Frame to enhance early stroke recovery
  - Development and evaluation of inter-disciplinary nurse training programme for stroke
  - TIA clinic/AF referral guideline evaluation trial.

Recent Grants

• Depression in the first weeks after stroke, Stroke Association, £250,000, with Professor Alan House, Leeds, (January 2001)
• A randomised trial evaluation of community hospital care for older people, PPP Healthcare Medical Trust, £173.328 (September 2000)
• Development of a primary care-based service for stroke aftercare, Stroke Association, £174,512 (September 2000)
• A randomised trial to evaluate a standing frame to hasten recovery from acute stroke, Regional R&D (NHS Executive), £58,049 (August 2000)
• Getting clinical evidence into practice for the management and prevention of stroke, £150,000, Wright, Young, Patterson, Harrison, Price, Russell, Small, Walsh (August 2001).

For further information, please contact:

Professor John Young,
Bradford Hospitals NHS Trust,
St Luke's Hospital,
Little Horton Lane,
Bradford BD5 0NA

Tel: (01274) 365311