Cheshire and Merseyside

The priorities of the Cheshire and Mersey Integrated Stroke Delivery Network (ISDN) are aligned to the Long-Term Plan, National Stroke Service Model, Getting it Right First Time GIRFT and NHS Cheshire and Merseyside Joint Forward Plan 2023-2028.

Stroke is the fourth single leading cause of death in the UK and the single largest cause of complex disability. Approximately 100,000 people in England have a stroke every year, and 50% of stroke survivors will be left with disability (physical, communication, cognitive, psychological, visual, fatigue). The stroke prevalence rate (people living with stroke) is higher than the national average in Cheshire and Mersey at 2.1% vs 1.8%.

It is imperative that as a wider stroke community we come together to improve the quality of stroke services in Cheshire and Mersey areas for our patients and our colleagues.

The key priorities for Cheshire and Mersey ISDN are:

• Improving recanalisation therapy (thrombolysis and thrombectomy) rate and performing these procedures in a timely manner. This will in turn mean better outcomes for stroke patients; however, success of both these procedures are time-dependent and needs timely response from the ambulance service both for primary transfer to the Acute Stroke Centre from the community and secondary transfer to the Thrombectomy centre. We would develop and implement strategies to meet the national ambulance response time on every occasion by working in partnership with the North West Ambulance service and developing a regional video-triage service.
• Transform post discharge rehabilitation and provide integrated, equitable, cost effective, evidence based and need based stroke specific community rehabilitation i.e. Integrated Community Stroke Service (ICSS).
• Link with the Cardiovascular and Respiratory (CVDR) networks to work collaboratively on both primary and secondary prevention and to develop common aetiological workup strategy for ischaemic and haemorrhagic stroke across the region.
• Work towards reducing health inequalities across the Stroke entire pathway from prevention to life after Stroke.
• Supporting transformation of Stroke Services in Cheshire and Mersey where identified.

The key priorities for Stroke in Cheshire and Mersey areas will be realised through collaboration with key stakeholders within the wider “system” such as other networks, multi-disciplinary clinical colleagues, management, executives, “Place” representatives, patient and public voice colleagues etc.

The Cheshire and Mersey ISDN as with all ISDNs nationally, is funded through non- sustainable funds provided by the National Stroke Team. Whilst the Cheshire and Mersey ISDN is funded using fund external to the ICB, it is a priority to forge stronger links with the ICB to enable further improvement of the quality of stroke services in Cheshire and Mersey areas.

The Cheshire and Mersey ISDN have identified that as the landscape of healthcare is changing, we must look to novel digital and technology solutions to enhance Stroke Services, particularly in the community. The Cheshire and Mersey ISDN have a number of projects that use technology to supplement existing resources.

Performance of stroke services in Cheshire and Mersey will be monitored against the ten key performance indicators (KPIs) set by the National Team using Sentinel Stroke National Audit Programme (SSNAP) metrics and any areas identified as requiring improvement will be targeted.