Stroke is the fourth leading cause of death in the UK and the single biggest cause of complex adult disability. Over 2,000 patients are admitted to hospitals across Lancashire and South Cumbria with a stroke each year and at least half of these will have some form of disability for the rest of their lives, many of which are severe and mean the stroke survivor can no longer live independently. This number is rising. Over twice this number attend Emergency Departments with the symptoms of a stroke, but which do not require specialist stroke care. Stroke costs the UK around £26 billion a year and the cost of urgent and acute stroke care in local hospitals is approximately £20 million a year.
These are huge and disturbing numbers, especially when taking into account the fact that a stroke, for the majority of cases, is a preventable disease. If it is possible to reduce the number of deaths and the number of people living with the impact of a stroke, then this should be done. We believe this is possible, and we are now seeking your feedback and support on the approved way forward to making this happen.
To make this happen, a full-scale review of the stroke service pathway (the journey someone who may have a stroke or who has had a stroke, from prevention through to long-term survivorship/end of life) has been underway since 2015. Its aim was and is to reduce deaths and disability by improving all stroke care and related services for the whole population of Lancashire and South Cumbria and ensure everyone has access to the same level of high-quality care, no matter where they live.
A new specification for the stroke care service pathway has been established which is in line with national guidance on stroke and has been co-created and endorsed by stroke survivors, professionals and other groups with an involvement or interest in stroke and stroke care. Some elements of the pathway, including prevention and integrated community stroke teams, are already seeing developments take place.
One of the major areas for enhancement is the acute stroke care provided in the stroke centres located in 5 hospitals within Lancashire and South Cumbria – Royal Preston Hospital, Blackburn Royal Infirmary, Blackpool Victoria Hospital, Lancaster Royal Infirmary and Furness General Hospital. A crucial factor in providing effective stroke care is the availability of qualified and experienced doctors, nurses and therapists throughout the care of a stroke patient. This is especially the case in the initial hyper-acute and acute phases of care and recovery, which are required during the first 72 hours after a stroke takes place. It is during this period that more recent medical advancements have taken place, such as thrombectomy and thrombolysis, which have a major impact on the effects of a stroke.
The proposals for improving acute stroke care services, which take into account these needs and developments, were originally considered in 2019 and the preferred option for how and where these services will be delivered was supported by stroke survivors, carers, stroke care professionals, the Stroke Association, and commissioners of these services.
Unfortunately, the arrival of the COVID-19 pandemic seriously impacted upon the development of the full business case for enhancing acute stroke care services, which, if agreed, would have allowed the proposals to be implemented. In stroke care, such delays impact upon the saving of lives and the level of lifelong disability stroke survivors can face.