A public consultation on reshaping stroke services has been launched, with plans to create specialised Hyperacute Stroke Units offering 24/7 access to faster diagnosis and cutting edge treatments. The central aim of the reforms is to significantly reduce disability and save more lives.
The proposed new network of Hyperacute stroke units will ensure that patients have access to the best possible care in regional centres of excellence no matter where they live or what time they are admitted.
It will lead to increased use of the clot busting Thrombolysis. The reforms will also support greater access to Thrombectomy, the groundbreaking procedure that removes a clot from the brain.
Thrombectomy is currently available at the RVH from Monday to Friday, over limited hours. The Hyperacute network model is essential to allow the expansion of Thrombectomy to a 24 hour, seven day a week service and to ensure that appropriate patients from across Northern Ireland can receive this life-changing treatment.
The public consultation offers six potential new models of care, with potential networks ranging from three Hyperacute Stroke Units to five.
Currently, there are eight acute hospitals routinely providing Thrombolysis to stroke patients.
Despite the dedication of our staff to provide high quality care within available resources, most of our hospitals currently struggle to consistently meet national best practice standards of care for stroke patients.
Permanent Secretary Richard Pengelly said: “We have an exciting opportunity to change services for the better, protecting many more people from the devastating consequences of stroke.
“We can’t secure these improvements without reshaping current provision.
“Our hospital stroke services are currently too thinly spread. Too many units are struggling to maintain sustainable quality care and staffing levels.
“Establishing Hyperacute Stroke Units is vital to ensure we keep pace with advances in treatment and provide the best possible treatment.
“The principle of consolidating care is backed by stroke charities, expert research and the proven success of reforms introduced in London and Manchester.”
The consultation on Reshaping Stroke Care will run for 12 weeks. It follows a pre-consultation by the Health & Social Care Board and Public Health Agency in 2017.
The consultation paper also outlines planned improvements in the treatment of Transient Ischemic Attack (TIA), also known as mini-stroke, as well as improvements to community-based stroke care.
The consultation also proposes extending the HEMS air ambulance service to coordinate with emergency road transport for patients with strokes and other conditions in remote rural areas to ensure they arrive at hospital for treatment as quickly as possible.
Notes to editors:
1. Thrombolysis is currently routinely provided at eight hospitals: Antrim, Causeway, Craigavon, Daisy Hill, Altnagelvin, South West Acute, Royal Victoria, and Ulster hospitals. It is estimated that 20% of stroke patients would benefit from thrombolysis. However, within current services, the number of people who receive thrombolysis ranges from 10% to 20% of stroke patients.
Thrombolysis is more effective the earlier it is given but there is also significant variation in the time it takes to provide thrombolysis (door to needle time). From October to December 2018, the percentage of stroke patients who received thrombolysis within one hour ranged from just under 40% to 100%.
2. Due to its highly specialised nature, Thrombectomy is provided at one site – the RVH – serving the whole of the province.
3. The public consultation is supported by expert research and modelling commissioned from the University of Calgary and the University of Exeter.
4. The public consultation report is available online.
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