Controversies in Management: Only hospitals can provide the required skills

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Abstract
Unfortunately both experience and formal clinical studies have taught us that coordinated rehabilitation is lacking in the community. This is confirmed by the nature of requests for information and support made to the Stroke Association.3 Coordinated care is possible in the community but difficult in practice. The professions concerned have different employers, patterns of referral, and work bases. Community nursing services offer significant input but tend to concentrate on the more disabled and those least likely to change. They provide a care service but not rehabilitation. Domiciliary physiotherapy is attractive, but the service is provided in only a few areas. Therapists have to deal with a varied caseload and many lack specialist expertise. Studies of the benefits of domiciliary physiotherapy and its cost effectiveness have produced conflicting results.4 Occupational therapy is available more often but consists …