Agenda item

To provide an update on the Enhanced Network Model of Acute Stroke Care and Rehabilitation in Lancashire and South Cumbria as previously agreed by the Committee.

Ms Sharon Walden, Project Manager, Acute and Specialised Services Portfolio, Lancashire and South Cumbria Integrated Care System (ICS), Ms Hayley Michell, Interim Project Director, Lancashire and South Cumbria Integrated Stroke and Neurorehabilitation Delivery Network (ISNDN) and Ms Catherine Curley, Clinical Director for Stroke in Lancashire and South Cumbria provided a presentation on the work to develop Stroke Services at Blackpool Victoria Hospital. It was noted that the aim of the work was to standardise stroke care across the whole ICS and it was acknowledged that a key driver of this work was that stroke services in Blackpool were behind those provided in other areas.

The presentation highlighted the key treatments required following a stroke and the importance of a speedy response. It was reported that Blackpool would be one of three stroke centres provided across the ICS and the key aims of he work were to reduce the number of deaths and the number of long term disabilities resulting from stroke. The programme was incremental over three years, and now, towards the end of Year 1 progress could already be evidenced.

The Committee queried whether the programme was meeting key targets in terms of recruitment and the deadline by which the hyper acute care would be provided at Blackpool Victoria Hospital. In response, Ms Walkden advised that the provision of hyper acute care was a final step in the programme and was scheduled to be in place by April 2024. She advised that a full timeline of implementation could be circulated and that recruitment was intended to be gradual over the three years of the programme.

In response to a question regarding reducing the length of stay by stroke patients, Ms Michell advised that improvements to ambulatory care and community rehabilitation would allow patients to be discharged from hospital as soon as they were medically well reducing the length of stay.

Members noted the challenges that Blackpool Victoria Hospital had in meeting targets to see patients arriving at the Emergency Department within four hours and questioned how the ICS could be sure that stroke patients were seen much more quickly. Ms Curley advised that the programme would put in place specially trained nurses who operated 24 hours a day, seven days a week at the ‘front door’. These nurses would triage arrivals, identify patients with a suspected stroke and put them immediately on the correct pathway.

In reference to the training of staff, Members were informed that due to Covid a simulation suite had been provided across the ICS to provide the essential training required and assurance was provided that staff in Blackpool had been adequately trained.

The Committee queried a number of statistics including the target for the use of thrombolysis and the number of deaths resulting from stroke. In response, Ms Walkden advised that thrombolysis must be undertaken within four and a half hours of the stroke to be effective. There was a national target of 15%, with hospitals across the region gradually increasing their use to between nine and 13%. She reiterated that its use depended on the circumstances of each individual patient. In relation to the number of deaths, it was acknowledged that 442 was close to 20% of all stroke patients and required improvement. Ms Walkden confirmed that a reduction in the number of deaths and the number of patients suffering from a long term disability following a stroke was a key priority of the programme.

The Committee agreed that a further report be received in approximately 12 months in order to ascertain progress and that the business case and timeline for the programme be recirculated.