Stroke

The NHS Long Term Plan set outs the ambitions for the NHS over the next 10 years, identifying stroke as a clinical priority. It outlines how we will work with partners to improve stroke care along the full pathway from symptom onset to ongoing care. This includes prevention, treatment and rehabilitation. Meeting the ambitions in the Long Term Plan would result in the NHS having the best performance in Europe for people with stroke.

What is stroke

Stroke is the leading cause of disability and the fourth largest cause of death in the UK.

stroke is a serious life-threatening medical condition that occurs when the blood supply to part of the brain is cut off.  The damage this causes can affect the way your body works, as well as how you think, feel and communicate.

Around 85,000 people a year are admitted to hospital with a stroke, and there are over 1 million stroke survivors in England, more than half of whom have a disability resulting from their stroke.

Some causes of stroke are genetic, however up to 70% of strokes could be prevented by the detection and effective management of hypertensionatrial fibrillationdiabetescholesterol and lifestyle factors such as smoking.  Stroke becomes more likely with age but 1 in 4 stroke survivors are working age adults.

NHS England’s work on stroke

The National Stroke Programme has been developed jointly by NHS England and the Stroke Association in consultation with a wide range of clinical experts and people affected by stroke. The programme will support local organisations to meet the ambitions for stroke set out in the Long Term Plan and deliver better prevention, treatment and care for the 85,000 people who have a stroke in England each year. It will ensure that the groundwork is laid for change in every area of the country. The programme aims to:

  • Improve post-hospital stroke rehabilitation models for stroke survivors
  • Deliver a ten-fold increase in the proportion of patients who receive a clot-removing thrombectomy to end their stroke so that each year 1,600 more people will be independent after their stroke
  • Train more hospital consultants to offer thrombectomy in more sites, providing a national service
  • Deliver clot-busting thrombolysis to twice as many patients, ensuring 20% of stroke patients receive it by 2025 – the best performance in Europe
  • Enhance the Sentinel Stroke National Audit Programme (SSNAP) to identify further need and drive improvements across the stroke pathway, including rehabilitation
  • Ensure three times as many patients receive 6 month reviews of their recovery and needs – from 29% today to 90%

We are working with the Stroke Association, NHS RightCare, Getting it Right First Time (GIRFT) and a range of professional bodies, along with other arm’s length bodies (ALBs) and voluntary sector organisations to deliver this national programme of work.

If you would like any more information on the stroke programme, please email england.clinicalpolicy@nhs.net.

As part of the national stroke programme we have worked with the Stroke Association to develop an online Future NHS platform for Stroke. The platform is an online space for stroke professionals to share ideas, questions and best practise, and collaborate to meet the NHS Long Term Plan ambitions and deliver a 21st century stroke pathway. If you’re interested in joining please contact england.clinicalpolicy@nhs.net.

Integrated Stroke Delivery Networks

The NHS Long Term Plan highlights the need for Integrated Stroke Delivery Networks (ISDNs) in all areas of England, bringing people and organisations together to deliver the best possible care for their population.

Led by Integrated Care Systems (ICSs) and Sustainability and Transformation Partnerships (STPs), ISDNs will include providers and commissioners of services across the whole stroke pathway.  ISDNs will be responsible for designing and delivering optimal stroke pathways, which will ensure that more people who experience a stroke receive high-quality specialist care, from pre-hospital, through to early supported discharge, community specialist stroke-skilled rehabilitation and life after stroke. Their development is key to delivering on the NHS Long Term Plan commitments for stroke.

The overarching aim of an ISDN is to enhance the quality of stroke care, by improving clinical outcomes, patient experience and patient safety. The ISDN does this by bringing key stakeholders together, to facilitate a collaborative approach to service improvement of the whole stroke pathway ensuring a patient centred, evidence-based approach to delivering transformational change.

By April 2021, all ISDNs will have an accountable governance structure in place that includes all relevant providers from pre-hospital care through to rehabilitation and end of life care. Having established links to all other relevant networks including regional GIRFT Implementation hubs, Primary Care Networks, Academic Health Science Networks and Strategic Clinical Networks, the ISDNs core focus is to agree priorities for delivery of the stroke components of the LTP and develop operational plans for clear patient pathways.

There are 20 ISDNs that have been developed and approaching the operational stage across England, covering the 7 regions;

  • North East and North Cumbria
  • Lancashire and South Cumbria
  • West Yorkshire and Harrogate
  • Humber Coast and Vale
  • South Yorkshire
  • Greater Manchester
  • Cheshire and Mersey
  • North Midlands
  • East Midlands
  • West Midlands
  • East of England (North)
  • East of England (South)
  • London
  • Thames Valley
  • Kent and Medway
  • Frimley and Surrey Heartlands
  • Sussex
  • Wessex
  • Gloucestershire, Bath and North East Somerset, Swindon & Wiltshire (BSW), Bristol, North Somerset & South Gloucestershire (BNSSG) and Somerset
  • Devon & Cornwall and Isles of Scilly (Peninsula)

If you would like more information on the ISDNs and if local areas have examples of best practice they believe could be replicated elsewhere, please get in touch with the National Stroke Programme Team at england.clinicalpolicy@nhs.net.

Resources