National stroke audit places NNUH in top hospitals nationally
The latest national audit of stroke care undertaken by the Royal College of Physicians today reveals that the Norfolk and Norwich University Hospital is ranked as one of the top performers nationally.
The report places NNUH in the top quartile of hospitals nationally and represents a significant improvement over recent years. Two years ago the Stroke Sentinel Audit placed NNUH in the bottom quartile.
The Royal College of Physicians (RCP) Stroke Sentinel Audit 2010 shows that 90% of patients with stroke received their care in a specialist acute stroke unit (up from 83% previously). NNUH was also one of only 28% of hospitals that provided 24/7 access to clot-busting thrombolysis treatment.
The Norfolk and Norwich University Hospital was also one of only 44% of hospitals nationally that had a specialist early supported discharge team and one of only 55% of centres nationally who could offer patients access to specialist community rehabilitation.
In January this year a new £8m dedicated stroke and general rehabilitation unit opened at the Norwich Community Hospital site on Bowthorpe Road, Norwich. The Mulberry Rehabilitation Unit houses the 24-bedded Beech Stroke Rehabilitation Ward.
Patients primarily from the central Norfolk area – encompassing Norwich, South and North Norfolk – are be admitted to the stroke rehab ward. Funded by NHS Norfolk (NHSN), the unit was the single biggest investment in any capital scheme since the primary care trust was established in 2006.
The Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH), in partnership with Norfolk Community Health & Care (NHC&C), manages the new stroke ward, with NCH&C providing services and staff. NCH&C is directly commissioned by NHSN to continue providing general rehab in the Alder Ward.
Dr Bryan Heap, Medical Director for NHS Norfolk, said: “This is excellent news for the Norfolk and Norwich University Hospital, and we congratulate everyone involved in the provision of stroke services at the Trust. To be in the top quartile of hospitals nationally is an excellent achievement.
“People in Norfolk can be assured that they are receiving the best stroke care we can provide. We are particularly proud of the 24/7 thrombolysis services for patients.
“NHS Norfolk’s £8m investment in The Mulberry Rehabilitation Unit shows our continued commitment to providing high quality stroke care for the county. We will take the needs of stroke patients very seriously, and will continue to do so in the future”.
Strokes happen when the blood supply, carrying essential nutrients and oxygen, to part of the brain is cut-off. This can be caused by a blood clot (ischaemic stroke) in a blood vessel or by a burst blood vessel (haemorrhagic stroke) that causes a bleed in the brain.
A stroke can leave brain cells damaged or destroyed, affecting body functions. For example, if a stroke damages the part of the brain that controls how limbs move, the person will have difficulty moving their arms. A stroke thrombolysis service was first introduced at NNUH in December 2008 and extended to a 24/7 service in June 2009.
FAST – Face, Arm, Speech, Time to call 999. FAST is a simple test to help people to recognise the signs of stroke and understand the importance of fast emergency treatment. The FAST acronym was created by the Stroke Association and is used to assess three symptoms:
- Facial weakness – Can the person smile? Has their mouth or eye dropped?
- Arm weakness – Can they raise both arms?
- Speech problems – Can you understand what they are trying to say? Are they speaking clearly?
- Time to call 999.
Since December 2008 thrombolysis treatment – or clot busting treatment – has been given to suitable stroke patients who arrive at the Norfolk and Norwich University 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 sees 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.
It is estimated that around 10% of stroke patients are suitable for the treatment.
A stroke can leave brain cells damaged or destroyed, affecting body functions. For example, if a stroke damages the part of the brain that controls how limbs move, the person will have difficulty moving their arms.
Symptoms occur suddenly and can include:
– numbness, weakness or paralysis on one side of the body (signs of this may be a drooping arm, leg or lower eyelid, or a dribbling mouth)
– slurred speech or difficulty finding words or understanding speech
– sudden blurred vision or loss of sight
– a severe headache.
But studies show that if the patient is treated immediately, the risk of long-term damage is reduced, which is why the FAST test is so important in spotting the signs.