Patient and public contribution is key to development of new stroke services pathway for BNSSG

Over the last four years, Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group (BNSSG CCG) has been working on developing the Healthier Together Stroke Services Reconfiguration Programme.

With input from the Stroke Health Integration Team’s Service User Group, the Programme team has been reviewing stroke services across the region to understand how changes can improve services and lead to better health for people who have a stroke.

The latest yearly figures from the CCG show that more than 1,300 people have had a stroke in the BNSSG region. As the region’s population is growing and getting older, it means that more people are likely to have a stroke and there will be a greater demand for stroke care in the area.

Stephen Hill is a Co-Director for Patient and Public Involvement (PPI) for the Stroke Health Integration Team (HIT), a member of the Bristol Health Partners Executive Group and a stroke survivor. He and Co-Director Chris Priestman, along with the Chair of the HIT’s Stroke Service User Group, Claire Angell, have been working in partnership with clinicians and researchers to make sure that the Programme accurately reflects the needs of people who have had a stroke as well as their families and carers.

Stephen said: “My involvement in Stroke HIT is about making a difference for those affected by stroke but it has also been an opportunity for me to retrieve my own identity after having a stroke.

“Stroke HIT’s involvement in a regional stroke care pathway was actually down to fate as it would seem. The Bristol Health Partners HIT model brings together experts from across clinical, public health, community and academic fields in the area and that was the ideal group to contribute to a programme that was intent on integrating care systems to improve stroke care. We were, as it seemed, in the right place at the right time.

“The work we’ve done truly shows the impact of involving stroke patients, their families and carers in this Programme and how it can have tangible outcomes. It is testament to the power of lived experience and how it should be a considered part of developing any health and care service.

“As a HIT we’ve also been able to benefit from the vast amount of expertise and experience of stroke community organisations, Bristol After Stroke and the Stroke Association, which has helped us set the foundation of our now very active and dedicated Service User Group.”

Stephen was recently appointed as a Lay Member of the National Institute for Health and Care Excellence (NICE) Committee set up to rewrite the national guidelines for stroke rehabilitation in adults, which recognises his work on the Stroke Reconfiguration Programme as part of Stroke HIT.

Rebecca Dunn, BNSSG Stroke Reconfiguration Programme Director said: “The patient voice and experience has been an integral part of the successful development of the pathway from the very start. From contributing to clinical pathway design, to co-designing the services with the needs of service users in mind to the development of life after stroke services, the insight from people with lived experience of stroke has been invaluable. We are very grateful for all the time and commitment that the members of the Stroke Health Integration Team have given to this project.”

Recently the Programme’s pathway achieved a key milestone of developing its pre-consultation business case which has been approved by Healthier Together and NHS England/NHS Improvement ahead of the public consultation planned for Summer 2021.

The Programme is aiming for implementation of the new pathway in 2022, starting with the community elements of the programme and then the hyperacute and acute stroke units.

Dr Phil Clatworthy, Consultant Stroke Neurologist at North Bristol NHS Trust and Director of Stroke HIT said: “The Programme changes will bring rehabilitation therapies much closer to home for people who have had strokes, make access to care more equitable across BNSSG and reduce the number of ‘handovers’ between services, to ensure that people feel better supported as they recover. It’s also important to note that not only will the changes improve the experience of stroke care and support, but they will reduce the number of people dying or becoming disabled due to stroke across the region.”

Image credit: Centre for Ageing Better