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 are also working to make further improvements across all stroke services, from prevention through to recovery and rehabilitation.
Community stroke rehabilitation will be delivered closer to home thanks to changes to the way patients are supported on leaving hospital. A new early supported discharge service began in November 2017, allowing adults to be transferred from an inpatient ward to a community setting to continue their rehabilitation therapy in their normal place of residence, with the same intensity and expertise they would receive in a hospital.
CCG clinical lead for Stroke and local GP, Dr Terry Lynch, said: “This approach will ensure we deliver intensive therapeutic rehabilitation care to patients, in their own home, wherever possible allowing them to regain independence according to their individual needs.
“Returning to the home environment empowers the individual and the family to take charge of their care and actively make decisions to fully understand how their day to day life can adapt in response to their changing needs.”
Wherever possible, stroke rehabilitation in a patient’s home is recognised as best practice, both locally and at national level. The new early supported discharge team – formed of both health and social care professionals - will provide personalised individual care, with ongoing support and clinical oversight from their own GP. In addition, through the Recovery Service, the Stroke Association will address practical, emotional and physical needs.
To enable these improvements, community stroke rehabilitation beds in Crawley Hospital are being relocated. The majority of inpatient stroke rehabilitation beds are moving to the recently redeveloped Piper Ward in Crawley Hospital. Piper Ward was refurbished in December 2016 and provides a modern, dementia friendly inpatient unit for patients. Inpatient rehabilitation will be provided by Queen Elizabeth Foundation in Banstead for Surrey residents to provide more convenient inpatient rehabilitation for people from this area.
These new pathways of care will deliver NHS Crawley CCG, NHS East Surrey CCG, and NHS Horsham and Mid Sussex CCGs’ long-term vision for stroke rehabilitation which aligns to national and local best practice evidence and guidance. Public engagement, undertaken by the CCGs, indicates that improving outcomes, supporting independence and reducing travel times are key priorities for service users, carers, and the public.
If you have any questions about these services or would like to discuss these changes in more detail then we would be happy to discuss with you.
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