Twenty ISDNs, covering the whole of England, have been in place since April 2021. The National Stroke Programme published the National Stroke Service Model (NSSM) in May 2021, which outlines best practice to ensure integrated stroke care across the whole system.

The National Stroke Programme and Getting It Right First Time (GIRFT) stroke programme have been working closely with RightCare to develop this Stroke Toolkit and assessment tool, to bring to life the NSSM, the subsequently published policy document Integrated Community Stroke Service (ICSS) Model, and the GIRFT National Stroke report 2022.

This toolkit provides ISDN’s and local stroke services with key actions to guide service improvement in the following pathway specific and across pathway system improvement priority areas:

• health inequalities
• prevention
• TIA management
• pre-hospital
• hyper acute and acute care
• rehabilitation and life after stroke
• workforce
• medicines optimisation
• technology.

For the first time, responses to the self-assessment questions included in the Stroke Toolkit can be submitted and stored within the pdf. Additionally, these questions are also available as a separate interactive assessment tool, which enables responses to be submitted, summarised, and explored.

Findings:

• 28% of people living with a SCI experience suicidal ‘ideation’ – frequent thoughts or ideas about committing suicide
•  47% of people living with a SCI reported experiencing mental health problems in one or more of the assessed mental health conditions
• 68% of people living with a SCI who accessed NHS psychological support have stopped because it was either “not appropriate for their condition” or “making their condition worse”

It’s really not just physical. The findings of this seminal research is a wake-up call for the NHS, healthcare planners and policymakers to provide better mental health support services for SCI people - and their unpaid carers - as a matter of urgency.

People with ME/CFS should receive individually tailored support focused on personal agreed goals and a range of approaches should be used depending on the patient's preferences and priorities.

The guideline makes it clear that any programme based on fixed incremental increases in physical activity or exercise, for example graded exercise therapy (GET), should not be offered for the treatment of ME/CFS. Discussions with stakeholders highlighted that the term ‘GET’ is understood in different ways and the guideline sets out clearly what is meant by the term.

The importance of ensuring that people remain within their energy limits when undertaking activity of any kind is also highlighted. The guideline recommends that any physical activity or exercise programmes should only be considered for people with ME/CFS in specific circumstances and should begin by establishing the person’s physical activity capability at a level that does not worsen their symptoms. It also says a physical activity or exercise programme should only be offered on the basis that it is delivered or overseen by a physiotherapist in an ME/CFS specialist team and is regularly reviewed.

Although cognitive behavioural therapy (CBT) has sometimes been assumed to be a cure for ME/CFS, the guideline recommends it should only be offered to support people who live with ME/CFS to manage their symptoms, improve their functioning and reduce the distress associated with having a chronic illness.

• redesigning services for patients with non-inflammatory painful musculoskeletal conditions.
• reducing hospital visits.
• improving access to care for rare conditions.

You will need a FutureNHS account to view this report, or you can watch:

• a short video summary of the report which includes key recommendations.
• the recording of a webinar about the report held on 1 October 2021.

You will need a FutureNHS account to view this report, or you can view a short video summary which includes key recommendations.

You will need a FutureNHS account to view this report, or you can watch a short video summary which includes key recommendations.

The GIRFT Ophthalmology report makes 22 recommendations that focus on:

• freeing up capacity so that more patients can be seen.
• reducing reliance on consultant care by making greater use of the wider team.
• reducing the risk of avoidable sight loss and protecting people's vision.

Watch a short video summary of the report

1. Empowering and educating patients and beyond.
2. Making use of technology.
3. Integrating expertise.
4. Looking again at surgical procedures.
5. Making the most of our teams.
6. Considering collaborations.

Each area is addressed with its own chapter in the report.