Major stroke services improvements reach decision-making stage

A series of recommendations to improve stroke services in Bristol, North Somerset and South Gloucestershire will be presented for decision next week.

Recommendations to improve emergency stroke care, ongoing hospital treatment, and rehabilitation will be presented to the NHS Clinical Commissioning Group’s Governing Body meeting on 1 February. The recommendations are designed to ensure that each year there are fewer deaths with more people living independently after stroke. The recommendations have been further developed by senior clinicians, health and care staff and people with lived experience of stroke following a public consultation in 2021.

Stroke is a serious condition, and one of the UK’s biggest killers. Each year 1,500 people in Bristol, North Somerset and South Gloucestershire experience a stroke, and 1 in 50 live with the long-term effects of the condition.

The recommendations include changes to:

• emergency stroke care, with the establishment of a single ‘Hyper-Acute Stroke Unit’ at Southmead Hospital, providing 24/7 emergency treatment for everyone in the area. Research shows that more people survive stroke and are able to live independently when specialised stroke services are located in one place.
• ongoing hospital treatment, with the establishment of an ‘Acute Stroke Unit’ at Southmead Hospital. More people would receive their ongoing care in a dedicated unit, where staff are specialists in stroke care. The unit would be located next to the ‘Hyper-Acute Stroke Unit’, significantly reducing transfers of care (where people are transferred from one ward or hospital setting to another) and improving patient experience. A specialist stroke workforce would be retained at the Bristol Royal Infirmary to support people with specialist needs who cannot be transferred to the Southmead Hospital units.
• inpatient rehabilitation through the establishment of two ‘Stroke Sub-Acute Rehabilitation Units’. These units would bring a range of specialist services and therapies together to improve inpatient rehabilitation support for people who have recovered from their stroke, but aren’t quite well enough to go home. One unit would be located at the Weston General Hospital site and a second unit at South Bristol Community Hospital.

In addition, the recommendations include enhancements to community rehabilitation through the establishment of a comprehensive Integrated Community Stroke Service, delivering improved support in people’s homes.

Dr Chris Burton, Clinical Lead for the stroke programme, said:

“It’s exciting to be bringing this set of recommendations forward for decision-making. They take on board what we heard through the consultation period and are designed to ensure that everyone in our area has the best possible opportunity to survive and thrive after stroke.

“Nine in ten people who responded to the consultation understood the case for changing how services are currently organised. At the moment, outcomes vary far too much depending on where you live and the time of day you have a stroke. We want to eliminate that variation completely and ensure that the very best specialist emergency care is available for everyone, 24/7.

“It’s also an opportunity to build in long-term support for stroke survivors to regain their independence and live well in the community through the creation of the Integrated Community Stroke Service. This will enable support seven days a week across a range therapies and social services, empowering more people and their families to manage their own health and wellbeing.

“The changes we are proposing will mean around 15 fewer stroke deaths every year, and big improvements in people’s outcomes – including the numbers of people able to return to their own homes and live independently after a stroke.”

Three key members of Bristol Health Partners’ Stroke HIT – Claire Angell, Stephen Hill and Chris Priestman – are stroke survivors and lived experience representatives for the stroke programme. Chris, who is Stroke HIT’s Lead for Public Involvement in Health Services, said:

“I am pleased to have been involved in the shaping and design of these proposals with other stroke survivors at each stage of the programme. It’s so important for the development of new services to take on board both the positive and negative personal experiences of local people alongside the expertise of local clinicians.

“I know from my own experience that stroke is a life changing event. The initial treatment you receive is the very start of a long journey of rehabilitation, therapy and adjustment. The proposals for the new stroke service address stroke care comprehensively, ensuring the best specialist support continues to be available for everyone in our area at each stage of the patient journey.”

View the Governing Body report and Decision-Making Business Case on the BNSSG CCG Governing Body Meeting page.