Improving your Stroke services
NHS organisations have been working together to improve stroke services for local people.
As a result of a review of stroke services in Sussex, begun in 2014, clinicians have recommended changes to how and where Brighton and Sussex University Hospitals NHS Trust (BSUH) provides its stroke services. BSUH currently provides emergency stroke services at the Royal Sussex County Hospital (RSCH) in Brighton and Princess Royal Hospital (PRH) in Haywards Heath.
Clinicians have recommended that BSUH centralise its emergency stroke services in Brighton. This means that emergency stroke services would not be provided at PRH, although specialist inpatient stroke rehabilitation would continue to be provided at the Sussex Rehabilitation Centre at PRH.
Surrey and Sussex Healthcare NHS Foundation Trust (SASH) is also part of the review and recommendations include that East Surrey Hospital continues to provide emergency stroke care as a Hyper Acute Stroke Unit. Work is on-going to further improve the quality of care that patients receive, including access to stroke rehabilitation.
Why have clinicians recommended the changes at BSUH?
The reasons for the recommendation are that:
- Bringing stroke services onto one site will enable all patients to be treated by experts with the highest levels of expertise and experience at any time of day or night.
- Evidence shows that centralising emergency stroke services in this way saves lives and improves patients’ chances of making a full recovery.
- Placing all emergency stroke services at RSCH means that stroke patients will also have access to other highly-specialised services they might need which are only available at RSCH.
- Although ambulance journeys for some patients will be longer, they remain within safe limits and clinicians say that it is better for patients to travel further if it means they can be sure of receiving the best treatment and outcomes.
- Patients, carers and members of the public say that they would be happy to travel further to be confident of getting the best treatment for a stroke.
Patient and public feedback (BSUH)
Patient and public representatives have been part of the team leading this work from the start and there has been significant public and patient input throughout the whole process.
We are aware that travel to RSCH is less straightforward for some relatives and carers. BSUH will therefore be reviewing visiting times to offer more flexibility and preparing a carers pack that will include information about visiting, ward routines, travel and parking. Outpatient follow-up appointments will continue to be provided at PRH in Haywards Heath if that is nearer for patients.
We have recently invited local stroke groups to consider the recommendations and give us their views on how they could be best implemented. We have also been running a survey for patients, the public and carers. This has now closed and you can view the feedback below:
Other stroke care improvements
In addition to improving emergency stroke care, we also want to make further improvements across all stroke services, from prevention through to recovery and rehabilitation.
There were some questions about this in our recent survey and we will also be carrying out further patient and public engagement events in 2017 to explore these issues in more detail.
What happens next?
The GP-led governing bodies of the CCGs and BSUH are supportive of the changes recommended by clinicians. There is also broad patient and public support and the review team are working through the most recent feedback received to ensure all the points raised have been considered in the implementation of the changes (for example the additional support that could be provided for families and carers who have further to travel to RSCH).
Brighton and Hove health overview and scrutiny committee (HOSC) and West Sussex Health and Adult Social Care Select Committee (HASC) have both signalled their support for the recommended changes and East Sussex HOSC will be discussing them in March. The changes and the process for reaching them also need to be approved by NHS England through their gateway assurance process. We expect this process to be concluded during April.
Before the changes are implemented they would then need to be formally signed off by the CCG and BSUH boards. If they are approved, the implementation could begin by the end of April. Many of the changes are already effectively in place due to the current temporary divert of stroke patients from PRH to RSCH. However, formal approval will enable BSUH to begin recruiting the additional staff to the stroke unit. Allowing 12 months for recruitment and training, all the enhancements would be fully implemented within a year.
Please contact us to find our more or if you have any questions or comments about the improvements we are making to local stroke services.
What is a stroke?
A stroke is a clinical emergency that requires immediate medical attention. It is a blood clot or bleed in the brain which can leave the patient with lasting damage affecting how the brain works, speech, mobility and sight.
Two factors are critical in ensuring that people who have a stroke have the best chance of making a full recovery. The first is time and the second is the skills and expertise of the hospital that they are admitted to. In addition, medical and technological advances in recent years have transformed treatment, making it possible to restore blood flow and improve brain function when areas of the brain are damaged.
There is much more information about stroke and how to prevent it on the NHS Choices website.
Stroke prevention and prompt treatment
You can significantly reduce your risk of having a stroke through a healthy lifestyle, such as eating a healthy diet, taking regular exercise, drinking alcohol in moderation and not smoking.
If you suspect that you or someone else is having a stroke, phone 999 immediately and ask for an ambulance.
The main symptoms of stroke can be remembered with the word FAST: Face-Arms-Speech-Time.
Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have dropped.
Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm.
Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake.
Time – it is time to dial 999 immediately if you see any of these signs or symptoms.
For more information about stroke, its causes, treatment and prevention, visit: www.nhs.uk/stroke