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Found 62 results
  1. News Article
    Stroke patients in England are waiting an average of almost seven hours for a specialist bed, double the wait reported before Covid. National performance against key measures collected by the Sentinel Stroke National Audit Programme has nosedived, with patients in England waiting an average of almost seven hours to be admitted to a specialist unit in 2022-23, compared to three and a half hours in 2019-20. NHS England guidance states that every patient with acute stroke should be given rapid access to a stroke unit within four hours. This time frame is considered critical, as patients can only be given clot-busting drugs, and treatments such as thrombectomy, which surgically removes a clot, within the first few hours of stroke onset. However, this was achieved in just 40% of cases last year (2022-23), down from 61% in 2018-19. Juliet Bouverie, CEO of the Stroke Association, urged ministers to give trusts what they needed to reverse the decline, saying: “Stroke is a medical emergency and every minute is critical. “We are very concerned to see that, far from improving over the last year, the proportion of stroke patients being admitted to a stroke ward within the timescale for thrombolysis has continued to decline. This is putting patient recoveries at risk and strain on the rest of the health system. “We believe that early supported discharge, when done correctly, with adequately resourced community teams, can help to alleviate capacity pressures in acute stroke units. However, this is not a silver bullet. There are longstanding workforce issues which are affecting patient flow in, through and out of stroke units and we call on DHSC to properly address these in the workforce plan.” Read full story (paywalled) Source: HSJ, 2 January 2024
  2. News Article
    A hospital has introduced a new artificial intelligence system to help doctors treat stroke patients. The RapidAI software was recently used for the first time at Hereford County Hospital. It analyses patients' brain images to help decide whether they need an operation or drugs to remove a blood clot. Wye Valley NHS Trust, which runs the hospital, is the first in the West Midlands to roll out the software. Jenny Vernel, senior radiographer at the trust, said: “AI will never replace the clinical expertise that our doctors and consultants have. "But harnessing this latest technology is allowing us to make very quick decisions based on the experiences of thousands of other stroke patients.” Radiographer Thomas Blackman told BBC Hereford and Worcester that it usually takes half an hour for the information to be communicated. He said the new AI-powered system now means it is "pinged" to the relevant teams' phones via an app in a matter of minutes. "It's improved the patient pathway a lot," he added. Read full story Source: BBC News, 7 December 2023
  3. Content Article
    This visual summary (link below) is for healthcare professionals to use together with people who have had a stroke to help start or inform conversations about all aspects of their care, and give them details on what care and support they should expect.
  4. News Article
    The failure of trusts to offer stroke patients the level of rehab required by standards introduced 10 years ago has not prevented the publication of new guidance which demands even higher performance. New guidance has been issued by the National Institute for Health and Care Excellence (NICE) which says recovering stroke patients should receive therapy for at least three hours a day, five days each week. Performance against this standard is not yet measured, but figures analysed by HSJ show nearly all units treating stroke patients are falling well short of the previous NICE standard issued in 2013. This required a much less ambitious 45 minutes per day. The figures suggest it is inconceivable the NHS will meet the new NICE rehab requirements in the near future. When they were launched, NICE said: “It shouldn’t be underestimated how important it is for people who have been left with disabilities following a stroke to be given the opportunity to benefit from the intensity and duration of rehabilitation therapies outlined in this updated guideline.” But Chartered Society of Physiotherapy chief executive Karen Middleton said there was no funding for physios to work on rehab, despite increases in staff supply. “Funding that we know is already limited is being prioritised to other things rather than into rehab,” she said. Read full story (paywalled) Source: HSJ, 29 November 2023
  5. News Article
    A new risk calculator will help to identify people with type 2 diabetes who are at high risk of developing heart and circulatory diseases with greater accuracy than ever before. By spotting high-risk individuals years in advance, doctors will be able to offer vital preventative treatment that can help save lives by warding off future heart attacks and strokes. The risk calculator is included in the new European Society of Cardiology (ESC) Guidelines advising doctors on the management of cardiovascular disease in people with type 2 diabetes, which were announced at the ESC’s annual Congress in August. There are around 4.5 million people in the UK with type 2 diabetes, and one third of adults with diabetes die from a heart or circulatory disease. The SCORE2-Diabetes risk calculator, published in the European Heart Journal, will allow doctors to estimate the risk of developing a heart or circulatory disease in the next 10 years, with much improved accuracy. Professor Sir Nilesh Samani, our Medical Director, said: “People with diabetes are overall nearly twice as likely to die of heart disease or stroke as those who do not have the condition. "This increased risk can be substantially reduced by interventions such as blood pressure control and statins, but this requires more accurate identification of those at increased risk. “SCORE2-Diabetes is a valuable advance that will allow doctors to tailor pre-emptive treatments for individuals with type 2 diabetes based on their personal risk of heart and circulatory diseases. "Such an approach is vital as clinicians in the UK and across Europe find new ways to reduce the high levels of ill health associated with diabetes.” Read full story Source: British Heart Foundation, 26 November 2023
  6. Content Article
    The Sentinel Stroke National Audit Programme (SSNAP) measures the quality and organisation of stroke care across England, Wales and Northern Ireland. The overall aim of SSNAP is to provide timely information to clinicians, commissioners, patients and the public on how well stroke care is being delivered. Processes of care are measured against evidence-based quality standards referring to the interventions that any patient may be expected to receive. This report presents data from more than 91,000 patients admitted to hospitals between April 2022 and March 2023 and submitted to the audit, representing over 90% of all admitted strokes in England, Wales and Northern Ireland. This data is summarised in key messages for both those who provide and those who commission stroke care in hospitals and the community, and presented in tables and charts.
  7. News Article
    Stroke patients should be offered extra rehabilitation on the NHS, say updated guidelines for England and Wales. The National Institute for Health and Care Excellence (NICE) had previously recommended 45 minutes a day. But it believes some patients may need more intensive therapy for recovery and is suggesting three hours a day, five days a week. Experts welcome the advice, but question how feasible it will be for a stretched health service to deliver. NICE accepts it may be "challenging", but it says patients and families deserve the best care possible. That includes help regaining speech, movement and other functions caused by the damage that happens to the brain during a stroke. NHS England has said increasing the availability of high quality rehabilitation is a priority. More people than ever are surviving a stroke thanks to improvements in NHS care, it added. Read full story Source: BBC News,18 October 2023
  8. News Article
    A primary school teaching assistant died from a stroke after hospital staff told her family that the life-saving treatment she needed was not available at weekends. Jasbir Pahal, 44, who had four children and was known as Jas, died in November last year after suffering a stroke. Her family was told she could only be treated with aspirin because a procedure to remove the blood clot was only available from 8am to 3pm, Monday to Friday. It has now emerged that the life-saving treatment, called mechanical thrombectomy, was available at an NHS hospital trust just a 40-minute drive away from the Calderdale Royal hospital in Halifax where she was being treated, but there were no arrangements for such transfers. Jasbir’s husband, Satinder Pahal, 49, said: “We have paid the ultimate price for this deficient service. Despite our pleas to save Jas’s life, all they could do was to give her an aspirin. “My wife was a vegetarian, never drank alcohol or smoked. She was fit and healthy and she wasn’t given the chance to survive. Jas was the centre of our worlds and her loss will impact us for ever.” The family are calling for urgent action to prevent future deaths." The Observer reported last month of warnings by the Stroke Association charity and clinicians about the regional variations in access to mechanical thrombectomy. It has been described as a “miracle” treatment, with some patients who were at risk of death or permanent disability walking out of hospital the day after the procedure. Read full story Source: The Guardian, 15 October 2023
  9. Content Article
    The Covid-19 pandemic had an adverse impact on the detection and management of cardiovascular disease (CVD) risk factors including hypertension. In June 2022, nearly two million fewer people with hypertension were recorded as being treated to target, compared with the previous year. As a result, NHS England commissioned the AHSN Network to deliver a new national Blood Pressure Optimisation (BPO) programme building on its portfolio of work around cardiovascular disease. This report lays out: evidence about the impact of the BPO programme how it has been received by frontline staff how it has been implemented nationally.
  10. News Article
    A district general hospital has accused a major teaching trust of ‘failing to adhere to arrangements’ made around the provision of acute stroke services, sparking patient safety warnings in a local integrated care board’s (ICB) risk register. Harrogate and District Foundation Trust’s accusation that its neighbour, Leeds Teaching Hospitals Trust, is failing to comply with protocol around acute stroke pathways was published in West Yorkshire ICB’s risk register. The ICB’s September risk register also said the “risk to patient safety is significant and probable if the situation remains unresolved”. The issues centre on the provision of hyper-acute stroke unit beds, which provide the first two to three days of care for patients with newly diagnosed strokes, and what happens to patients requiring acute stroke care following their initial HASU stay. West Yorkshire ICB said in its September’s performance report that the problem had “grown due to two recent clinical incidents,” but added “there is no quick solution to this problem”. Harrogate has raised concerns with the ICB in recent months that “a number of patients are not receiving HASU level care at Leeds”. Read full story (paywalled) Source: HSJ, 3 October 2023
  11. News Article
    Doctors missed a man’s stroke which led him to suffer another one and go temporarily blind. The man said that the experience had changed him from ‘an outgoing social person, to a sheltered man living in fear that he is not being looked after competently’. The 75-year-old visited his GP in Darlington complaining of dizziness, light-headedness, and a numb foot. He had experienced a stroke and should have been immediately sent to hospital. But doctors missed the signs, diagnosed him with a ‘dropped foot’ and requested an urgent MRI scan. However, due to an administrative error the referral wasn’t made and the scan never happened. A month after visiting the GP, the man suffered a blinding headache and diminished vision. He saw an ophthalmologist who referred him to a specialist team. He had suffered another stroke. He also paid for a private scan which confirmed the first stroke happened a month earlier. Distressingly, the man lost vision in his right eye, which he was told could be permanent. Fortunately, his sight returned eight weeks later. His daughter, who described the experience as ‘horrendous’, complained to the Parliamentary and Health Service Ombudsman (PHSO) about her father’s care. The PHSO found that the initial symptoms were signs of a problem with nerve, spinal cord, or brain function. Doctors should have suspected a stroke and immediately sent him to hospital. If that had happened, the second stroke and sight loss would likely have been avoided. Ombudsman Rob Behrens said: “Having a stroke and then being told you could be permanently blind must have been incredibly frightening. The impact on the man, and his family who supported him through the ordeal, will have been deep and long-lasting. “Mistakes like these need to be recognised and acted upon so that they are not repeated.” Read full press release Read case file Source: PHSO, 4 October 2023
  12. Content Article
    A report has been published by Healthcare Inspectorate Wales (HIW) setting out the findings of a review of patient flow in Wales. Patient flow is the movement of patients through a healthcare system from the point of admission to the point of discharge. HIW specifically examined the journey of patients through the stroke pathway. This was to understand what is being done to mitigate any harm to those awaiting care, as well as to understand how the quality and safety of care is being maintained throughout the stroke pathway.
  13. News Article
    The Government must provide the health service with more support to fulfil its ambition of extending healthy life expectancy and reducing premature death, an expert has warned. It comes after the Department for Health and Social Care (DHSC) published an interim report on its Major Conditions Strategy, a 5-year blueprint to help manage six disease groups more effectively and tackle health inequality. The groups are cancer, cardiovascular disease – including stroke and diabetes – musculoskeletal conditions, chronic respiratory diseases, mental health conditions and dementia. The Government said the illnesses "account for over 60% of ill health and early death in England", while patients with two or more conditions account for about 50% of hospital admissions, outpatient visits, and primary care consultations. By 2035, two-thirds of adults over 65 are expected to be living with two or more conditions, while 17% could have four or more. Sally Gainsbury, Nuffield Trust senior policy analyst, said the Government is right to focus on the six conditions, but "will need to shift more of its focus towards primary prevention, early diagnosis, and symptom management". She added: "What's less clear is how Government will support health and care systems to do this in the context of severe pressures on staff and other resources, as well as a political culture that tends to place far more focus on what happens inside hospitals than what happens in community healthcare services, GP practices and pharmacies. This initiative is both long overdue and its emphasis has shifted over time. The Major Conditions Strategy is being developed in place of a White Paper on health inequalities originally promised over 18 months ago." Read full story Source: Medscape, 16 August 2023
  14. Content Article
    The major conditions strategy is a national framework being developed by the Department of Health and Social Care (DHSC) and the Office for Health Improvement and Disparities (OHID). It will focus on six major groups of conditions: cancers cardiovascular diseases, including stroke and diabetes chronic respiratory diseases dementia mental ill health musculoskeletal disorders This briefing by NHS Confederation examines how the upcoming major conditions strategy can set the conditions to prevent, treat and manage multimorbidity in England.
  15. News Article
    Dozens of patients died or suffered ‘severe harm’ after long waits for ambulances during a three-month period in a health system facing ‘extreme pressure’ on its emergency services. The 29 serious incidents in Cornwall included patients waiting many hours for assistance despite being in “extreme pain”, patients having suspected sepsis, patients in cardiac arrest, and patients experiencing a stroke. The incidents were reported to the Care Quality Commission by staff at South Western Ambulance Service Foundation Trust during an inspection of the Cornwall integrated care system’s urgent and emergency care services. According to the CQC, the pressures on the ambulance service were “unrelenting”, while “significant work” was needed to “alleviate extreme pressure”. This meant there was a “high level of risk to people’s health when trying to access urgent and emergency care in the county”, the report said. Read full story (paywalled) Source: HSJ, 27 May 2022
  16. News Article
    National NHS officials have called for ambulance response times for stroke cases to be “urgently reviewed”. A report on stroke services by Getting it Right First Time – an NHS England national programme – recommends modelling the impact of a change to the categorisation by ambulance services of suspected strokes. The GIRFT report notes that the time between symptom onset and arrival at hospital has increased by 41 minutes over the last seven years, yet faster access to emergency stroke care gives a better chance of survival and reduces the impact on quality of life for survivors. Strokes are currently treated as “category two” incidents, meaning they should get a response within 18 minutes. However, patients are currently experiencing much longer waits, as average response times were more than three times this in March. Since the introduction of the current system of categorisation in 2017-18, the 18 minute target for category two calls was only ever hit for a few months, at the height of the covid pandemic, when call-outs were abnormally low. However, when asked about the issue, Janette Turner, the academic who led research on the last official review of ambulance response times, warned that moving all suspected strokes to category one could lead to longer responses for the most serious calls. Read full story (paywalled) Source: HSJ, 4 May 2022
  17. News Article
    Stroke and heart attack victims are now routinely waiting more than an hour for an ambulance, after a further fall in performance in recent weeks, and with hospital handover delays hitting a new high point, HSJ reveals. Figures for ambulance performance this week, seen by HSJ, showed average response times for category two calls at more than 70 minutes for successive days. 3,000 patients may have suffered “severe harm” from delays in February, ambulance chief executives say. Several well-placed sources in the sector said response times had deteriorated further this month, and that more than half of ambulance trusts were this week seeing average category two responses of longer than an hour. Some cited an average category two response last week of around 70 minutes, with the services under huge pressure from a combination of demand, long handover delays, and covid-related sickness. Category two calls include patients with suspected heart attacks and strokes, and the national target for reaching them is 18 minutes. The figures seen by HSJ for this week showed average response times for category one calls — the most serious, including cardiac arrests and other immediately life threatening emergencies — of more than 10 minutes on Wednesday, against a target of just 7 minutes. Monthly average performance for category one has never reached 10 minutes. Read full story (paywalled) Source: HSJ, 1 April 2022
  18. News Article
    Artificial intelligence (AI) is set to be rolled out more widely across the NHS in a bid to diagnose diseases and treat patients faster. The Government has announced a £21 million funding pot that NHS trusts can apply for to implement AI tools for the likes of medical imaging and decision support. This includes tools that analyse chest X-rays in suspected cases of lung cancer. AI technology that can diagnose strokes will also be available to all stroke networks by the end of 2023 – up from 86% – and could help patients get treated faster and lead to better health outcomes. The Department of Health and Social Care (DHSC) said the technology could help cut NHS waiting lists ahead of winter. Read full story Source: The Independent, 23 June 2023
  19. News Article
    People would rather go to England if they had a stroke than use the A&E at a north Wales hospital, a health watchdog has said. Inspectors said there was a "clear and significant risk to patient safety" after inspections at the department in Ysbyty Glan Clwyd, Denbighshire. North Wales Community Health Council's Geoff Ryall-Harvey said it was the "worst situation" they had seen. The report said inspectors found staff who were "working above and beyond in challenging conditions" during a period of "unrelenting demand". Many staff told them they were unhappy and struggling to cope. They said they did not feel supported by senior managers. However inspectors said that the health board was not fully compliant with many of the health and care standards, and highlighted significant areas of concern, which could present an immediate risk to the safety of patients, including: Doctors were left to "come across" high-risk patients instead of being alerted to them. Patients were not monitored enough - including a suspected stroke patient and one considered a suicide risk. Children were at serious risk of harm as the public could enter the paediatric area unchallenged. Inspectors found evidence of children leaving unseen or being discharged against medical advice. Betsi Cadwaladr health board said it was committed to improvements. Read full story Source: BBC News, 8 August 2022
  20. News Article
    A new report by the Stroke Association released today warns that, if the thrombectomy rate stays at 2020/21 levels, 47,112 stroke patients in England would miss out on the game changing acute stroke treatment, mechanical thrombectomy, over the length of the newly revised NHS Long Term Plan. This year, NHS England missed its original target to make mechanical thrombectomy available to all patients for whom it would benefit – only delivering to 28% of all suitable patients by December 20212. The Stroke Association’s ‘Saving Brains’ report calls for a 24/7 thrombectomy service, which could cost up to £400 million. But treating all suitable strokes with thrombectomy would save the NHS £73 million per year. Stroke professionals quoted in the report cite insufficient bi-plane suites, containing radiology equipment, as a barrier to a 24/7 service. The Stroke Association is calling for: The Treasury to provide urgent funding for thrombectomy in the Autumn Budget 2022, for infrastructure, equipment, workforce training and support, targeting both thrombectomy centres and referring stroke units. Department of Health and Social Care to develop a sustainable workforce plan to fill the gaps in qualified staff. NHS England to address challenges in transfer to and between hospitals in its upcoming Urgent & Emergency Care Plan. Putting innovation - such as artificial intelligence (AI) imaging software and video triage in ambulances - into practice. Juliet Bouverie, Chief Executive of the Stroke Association said: “Thrombectomy is a miracle treatment that pulls patients back from near-death and alleviates the worst effects of stroke. It’s shocking that so many patients are missing out and being saddled with unnecessary disability. Plus, the lack of understanding from government, the NHS and local health leaders about the brain saving potential thrombectomy is putting lives at risk. There are hard-working clinicians across the stroke pathway facing an uphill struggle to provide this treatment and it’s time they got the support they need to make this happen. It really is simple. Thrombectomy saves brains, saves money and changes lives; now is the time for real action, so that nobody has to live with avoidable disability ever again." Read full story Source: The Stroke Association, 28 July 2022
  21. News Article
    The NHS and the Treasury need to make a renewed commitment to increasing the number of patients who benefit from thrombectomy, the Stroke Association has said, as it revealed the service was dependent on just 106 doctors in England. New analysis due to be published by the charity later this week – and shared with HSJ – also found only a quarter of thrombectomy units are open 24 hours, seven days a week, with 42% only operating during office hours and Monday to Friday. Despite an NHS long-term plan target of treating 10% of strokes with a thrombectomy by this year, only 2.8% were benefitting in December 2021 – a smaller proportion than in the US or some other Western European nations. It means nearly 6,000 people who could benefit from thrombectomy are missing out, the charity has calculated. The Stroke Association’s report also highlighted large apparent regional variation in the share of stroke patients receiving the treatment — with London patients several times more likely to receive the treatment than elsewhere. Read full story (paywalled) Source: HSJ, 27 July 2022
  22. News Article
    Striking ambulance workers in two regions have said for the first time that they will only answer immediately life-threatening calls — abandoning previous agreements to cover some Category 2 incidents. Agreed exemptions (derogations) from ambulance strike action so far this winter have varied regionally and across different unions; but all have so far included some Category 2 cover. However, GMB told HSJ its members in the North East and North West today would cover only Category 1 calls – defined as “immediately life threatening” – during their action today. Category 2 includes more than any other category, and covers a wide range of incidents including suspected heart attacks and strokes. Read full story (paywalled) Source: HSJ, 20 February 2023
  23. News Article
    About 15 million more people in England could be prescribed daily cholesterol-lowering statin pills to cut their risk of heart attacks and stroke, new advice for the NHS says. Given the very cheap price of the tablets and the possible health gains, they should be considered more often, the draft guidance says. There can be side effects though and there is debate about how widely this long-term treatment should be given and what associated risks are acceptable. The National Institute for Health and Care Excellence (NICE), which advises the NHS, says people should be thoroughly assessed before statins are prescribed, warning the pills are not a quick fix or substitute for a healthy diet and exercise. The previous advice was for anyone with a one in 10 chance of having a cardiovascular event, such as a heart attack or stroke, within the next 10 years - based on factors such as age, blood pressure and cholesterol levels - to be offered a statin. But NICE now says including adults with a one in 20 chance could save 2% of them from having a heart attack or stroke during that period. Spokesman Paul Chrisp said patients should discuss the benefits and risks with their doctor, adding: "The evidence is clear, in our view, that for people with a risk of 10% or less over 10 years, statins are an appropriate choice." Read full story Source: BBC News, 12 January 2023
  24. News Article
    A Labour government would reverse the rise in the number of deaths from suicide as part of a health plan to replace pain and anxiety with a “hope of a renewed NHS”, Keir Starmer will pledge. In a speech today, the Labour leader will say his plan for reforming the NHS will focus on the biggest causes of death in the UK including suicide. He will point to coroners’ statistics showing that deaths from suicides have been rising since 2008, and reached a record high last year in England and Wales. If the party takes power Labour will reverse this rise within five years, Starmer will say. A segment of his speech previewed by the party says: “Suicide is the biggest killer of young lives in this country. The biggest killer. That statistic should haunt us. And the rate is going up. Our mission must be and will be to get it down.” Labour has not provided details on how it proposes to meet this pledge other than an aspiration to shift from “sickness to prevention”. Starmer will also propose introducing new NHS targets on cutting deaths in England from heart disease and strokes by a quarter over 10 years. Read full story Source: The Guardian, 21 May 2023
  25. News Article
    Covid-19 has dropped out of the top five leading causes of death in England and Wales for the first time since the start of the pandemic, figures show. Coronavirus was recorded as the main cause of death for 22,454 people in 2022, or 3.9% of all deaths registered, making it the sixth leading cause overall. In both 2020 and 2021 Covid-19 was the leading cause of death, with 73,766 deaths (12.1% of the total) and 67,350 (11.5%) respectively. By contrast, dementia and Alzheimer’s disease was the leading cause in England and Wales in 2022, with 65,967 deaths registered (11.4% of the total), up from 61,250 (10.4%) in 2021. The other causes in the top five were ischaemic heart diseases (59,356 deaths and 10.3% of the total); chronic lower respiratory diseases (29,815 deaths, 5.2%); cerebrovascular diseases such as strokes and aneurysms (29,274 deaths, 5.1%); and trachea, bronchus and lung cancer (28,571 deaths, 5.0%). Read full story Source: The Independent, 11 April 2023
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