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Review of hyper-acute stroke services

 

The NHS in Knowsley, Liverpool, South Sefton, Southport & Formby and West Lancashire is reviewing local hyper-acute stroke services – the hospital care provided immediately after someone has a stroke.

Currently, hospital stroke services for most people in these areas take place at the Royal Liverpool Hospital, Aintree University Hospital, and Southport Hospital. The Walton Centre doesn’t have a stroke unit, but it provides a type of treatment called thrombectomy – a special procedure for people whose stroke has been caused by a blood clot. Local clinicians think that bringing our local hyper-acute stroke services together could improve care for patients by saving lives and reducing disability. You can read more about why this is further down this page.

 

Patient engagement

During autumn 2019 we worked with the Stroke Association to visit a number of local groups for stroke survivors, to talk about the review and gather feedback from those with experience of hospital stroke services. You can read a report about this engagement here.

The information gathered from discussions with stroke survivors, their families and carers, will be used to help develop plans for how services could look in the future. No decisions about services have been made at this stage – if we were proposing changes which would affect the way that patients access services we would hold a public consultation to give people a chance to comment on our proposals. We expect to be able to give a further update on this work during summer 2020 – if you sign up to our database we’ll let you know when there’s more information.

Although our discussions during autumn 2019 were about hospital services, we also received feedback about other parts of stroke care, including people’s experience of rehabilitation and support services once they left hospital. In January 2020, NHS England published a new national service specification for early supported discharge and community care following a stroke. This document describes the care that people can expect to receive, but currently there are different levels of service in place both locally and nationally. NHS England has indicated that in summer 2020 it will ask local areas to apply for funding to introduce the new specification as pilot schemes. Locally we are committed to making a bid for this funding to roll out the new specification as early as possible.

 

Why are we looking at hyper-acute stroke care? The case for change…

The way that local stroke services are currently organised doesn’t allow us to meet best practice guidelines for providing the very highest quality care, or make the most of our specialist staff.

There is an international shortage of specialist stroke nurses, therapists and doctors, and our local expertise is currently spread across three different sites. This makes it very difficult to make sure that patients have access to the care that they need all of the time, especially during the critical period immediately after a stroke has taken place.

The care that people receive straight after having a stroke can make a big difference to their recovery. We want to give people the best chance of getting specialist treatments as soon as possible. This means making sure that stroke patients see specialist stroke staff who can make fast decisions about their treatment – and have access to the specialist scanning equipment needed to help make these decisions – and we believe we can only do this locally by bringing these teams together to provide the most urgent stroke care.

Estimates suggest that we could save the lives of around 26 local people each year if brought our hyper-acute stroke services together. 

In other areas of the country, such as Manchester and London, hyper-acute stroke care has been centralised into a smaller number of well-equipped and staffed hospitals, which has delivered big improvements in care and better outcomes for patients.