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Improving stroke care

Diagram of care pathway

We are one of 20 NHS England Integrated Stroke Delivery Networks that are responsible for delivering the national service model, led by the nation’s stroke programme.

Our region is well advanced in implementing the model, and has pioneered many aspects of the pathway. We are focused on:

  1. Preventing stroke
  2. Optimising the ambulance pathway
  3. Improvements to inpatient care
  4. Enhancing integrated community rehabilitation services
  5. Life after stroke

Underpinning these programmes has been the training and education of staff, with significant involvement from our Patient and Carer Group

1. Preventing stroke

Most strokes could be prevented and we are working within the Greater Manchester Integrated Care System to bring together cardiovascular disease prevention. We work closely with the diabetes and cardiac programmes within the  Strategic Clinical Network, and share a Clinical Lead to spearhead our efforts. Find out more here.

3. Optimising the ambulance pathway

85% of suspected stroke patients arrive at hospital by ambulance. Ensuring ambulance clinicians recognise stroke symptoms and take patients to the correct hospital for their needs has been our a focus, with our Facilitator Chris Ashton (a Paramedic) leading our efforts.

Improved education and training helps clinicians make the right decisions more rapidly, however, the professional development of ambulance staff can be challenging due to the constant pressures on the service, with staff turnover another barrier.

We have worked to improve the understanding of ambulance clinicians by:

  • Releasing a mobile phone application that supports ambulance clinicians compliance with the Greater Manchester acute care pathway (now superseded by an ambulance service app)
  • Lecturing at local universities to student Paramedics and Technicians
  • Collaborating with the Scottish Ambulance Service to produce a local version of their FAST assessment training video
  • Working with the College of Paramedics to host training events for ambulance staff
  • Facilitating an improved line of reporting and improved relationships between ambulance and hospital staff so crews can learn from their experiences of caring for stroke patients

4. Improvements to inpatient care

We continue to refine our centralised hospital stroke care pathway using data to drive improvements. We have a Document Pack of agreed Standard Operating Procedures and policies to that help ensure the consistency and quality of care.

We have implemented a pathway for Intracerebral Haemorrhage, have introduced a regional Intra Arterial Thrombectomy service and are working to extend local TIA services across the weekend using a sector based approach.

5. Implementing integrated community rehabilitation services

We have collaboratively developed a community care model that ensures all patients leaving hospital are supported by a specialised rehabilitation team. We are the only region to have fully implemented the model which now forms the basis for the national stroke community model. Find out more here.

6. Life after stroke

We are rolling out the NHS England life after stroke model across the conurbation in a step wise approach. We are working with local stakeholders including the voluntary sector to help deliver this vision equitably across our region