Agenda item

To update the Committee on the improvements made to Stroke Services and the proposed models of care.

Ms Hayley Michell, Interim Programme Director, Ms Elaine Day, Lancashire and South Cumbria Integrated Stroke and Neurorehabilitation Delivery Network (ISNDN) Manager, Ms Sharon Walken, Programme Manager and Mr Mark XXXXXX provided a presentation to update the Committee on the progress made in implementing the change in whole system approach to stroke services across the Lancashire and South Cumbria Integrated Care System (LSC).

It was reported that 6,409 people attended a hospital emergency department in LSC with either stroke or stroke mimic symptoms in 2020/2021. There had been 2,575 patient admissions for acute stroke care and 442 deaths due to stroke in 2020/21. Thrombolysis and thrombectomy rates, both treatment types for stroke, were well below national averages. In order to address concerns regarding stroke treatment in the area, a series of priorities had been established for implementation over a three year period.

A business case had been produced at the outset of the programme which had made a number of assumptions regarding the number of patients to be expected, however, in reality the number of presentations at the emergency department had been much higher with a 15% increase in the number of strokes in addition to an increase in stroke ‘mimics’. It had therefore been determined that a review of the business case was required which would be refreshed to reflect changes and the implementation plan updated with new timescales.

Members raised concerns regarding the wait times at the emergency department and in particular the length of time some ambulances were waiting outside the hospital before patients were able to be triaged. In response, it was reported that suspected stroke and heart attack continued to be prioritized and that ambulances could alert the emergency department in advance of their arrival that a patient was presenting with stroke symptoms. The importance of quick treatment was highlighted and it was noted that the stroke team was in attendance to meet patients that presented at the emergency department with symptoms for immediate triage. The same pathway was available for those self-presenting at the emergency department.

Further concern was raised by those in attendance that in Blackpool people appeared to present themselves later than in other areas and whether stronger messaging could be used in order to encourage them to attend the emergency department as quickly as possible after experiencing symptoms. It was agreed that a new set of messaging would be developed and presented to the Committee for comment and input.

The Committee also requested that data specific to Blackpool be presented so the immediate local picture of stroke could be understood. It was noted that the improvements continued to be a work in progress and Members requested that a further update be provided in due course.

The Committee agreed:

1.      To receive the material developed to encourage members of the public to seek help immediately following experiencing stroke symtoms.

2.      To receive a further update on the implementation of the programme in due course.

3.      To receive stroke data specific to Blackpool.