Life-saving service launched for stroke patients

A new service aimed at reducing the number of deaths and disabilities caused by stroke is to be launched in Norfolk this year, health chiefs heard today.

Patients are already benefiting from a pilot Thrombolysis Service which was launched at the Norfolk and Norwich Hospital (NNUH), in Norwich in December. A similar pilot is expected to be launched at the Queen Elizabeth Hospital (QEH), in King’s Lynn this year.

Today NHS Norfolk’s Board heard how the successful pilots would be used as a base model to further develop a permanent Thrombolysis Service across its patch.

Thrombolysis treatment – or clot busting treatment – is given to suitable stroke patients who arrive at hospital within three hours of onset of acute stroke. It can have a major impact on the patient’s recovery and reduce the risk of brain damage and resulting disabilities.

The service will see patients being met at the hospital by a specialist team of nurses and doctors who work with A&E staff and the admissions unit to confirm the stroke diagnosis. Once a brain scan has been done the decision to begin thrombolysis treatment is made by a consultant specialising in stroke.

With over a thousand patients with acute stroke are admitted to the NNUH and QEH each year and, when the service is fully developed, it is estimated that around 10% of these patients will be suitable for the treatment.

Dr Ian Mack, a member of NHS Norfolk’s clinical executive and a GP, said this development was really good news for stroke patients and would see significant improvements in services right across NHS Norfolk’s area.

“In May we announced how we were commissioning a more ‘joined up’ Stroke Care service with more specialist care for patients in their own homes, as well as within specialist health facilities, all aimed at ensuring our patients had better access to better services, and therefore a much greater chance of recovery from stroke.

“We can already see some of the results rolling out, and as more of these services begin to come on line it will all work to make sure a patient’s ‘journey’ through health services is seamless – from an emergency hospital admission through to community-based rehabilitation,” he said.

The Thrombolysis Service is the first of many new stroke services which NHS Norfolk has commissioned from the NNUH and the QEH.

In an update paper to the Board members heard how the dedicated Stroke Rehabilitation Unit based in central Norfolk, to be managed by the NNUH, was due to open by October. In the interim, stroke rehabilitation beds have been provided on wards at Dereham and Norwich Community Hospitals.

There will also be improved specialist community rehabilitation and after-care right across NHS Norfolk’s patch, including care to be provided in the patients’ own home.

Stroke Care Services:

A review of existing Stroke Care Services in 2007 underlined how deaths and disabilities could be reduced by quicker access to specialist clinical care after a stroke.

The review led to the creation of the Stroke Service Specification for NHS Norfolk, developed in collaboration with doctors and other clinical specialists from both acute hospitals and staff from community services. It identified a set of key targets for how services should be commissioned and delivered, including:

• Improving the overall quality and effectiveness of services for patients who have had a stroke or a transient ischaemic attack (TIA)

• Increasing and improving early identification of the risks of a patient having a stroke and early interventions from primary and community care health workers

• Shortening the length of time between the onset of a stroke or TIA and a patient’s access to specialist clinical services

• Access for a comprehensive, all-age, stroke rehabilitation service across the county

A ‘specification’ for Stroke Care Services – or a plan for how services should be provided – was developed in collaboration with doctors and other clinical specialists from the NNUH and QEH and community services and agreed at NHS Norfolk’s Board in July 2007.

The specification allows the patient a seamless transition through assessment, treatment, rehabilitation and going home. The combined care model also gives patients access to rehabilitation from day one.

Another important factor is the future development of a 24/7 thrombolysis – or clot busting – service which is a treatment which when given to suitable patients early enough can have a major impact on their recovery from stroke.

It also aims to increase and improve early identification of those at risk of stroke and intervention within the community. This includes the detection and management of hypertension, cholesterol and diabetes and work to reduce smoking and obesity, all of which can increase the likelihood of stroke.

In addition, the new strategy ensures stroke patients gain access to scans within 24 hours and sooner if needed after stroke / TIA, physiotherapy assessment within 72 hours and occupational therapy assessment within seven days of hospital admission.

Systems are also being put in place to ensure coordination and continuation of specialist care following discharge home.

Tuesday 27th of January 2009 04:00:26 PM