Noble’s Hospital is enhancing stroke care with two new initiatives as part of the Island’s five year stroke strategy.

The move follows a visit by a respected group of clinicians from the Royal College of Physicians. The team was invited to visit the Island to advise the Department of Health and Social Care on the phased implementation of its stroke strategy.

The strategy has a number of objectives, including:

• The development of a single stroke ward for acute care and rehabilitation
• The introduction of a thrombolysis service to break down blood clots, where they are the cause of stroke
• Review clinic structures to provide multidisciplinary reviews and further improvement of a ‘mini-stroke’ service to reduce unnecessary hospital admissions
• Review and development of community rehabilitation for stroke to improve recovery and reduce hospital lengths of stay.

The first initiative, already underway, is the trial of a new approach to inpatient stroke care which uses a single ward for stroke patients – from admission through to rehabilitation and discharge – instead of splitting care across two wards.

The team from the Royal College – led by Professor Tony Rudd CBE, National Clinical Director for Stroke with NHS England, Chair of the Royal College of Physicians Intercollegiate Stroke Working Party and Consultant Stroke Physician at Guys and St Thomas’ NHS Foundation Trust in London – suggested that a single stroke ward would enhance care for patients in a number of ways:

• Better continuity of care, with all inpatient treatment taking place in a single, dedicated and specialist ward environment
• The ability to have therapy staff – who provide rehabilitation – embedded in the ward, enabling more effective collaboration and multidisciplinary working
• The possibility of having a higher number of nursing staff on the ward instead of spread over two wards.

The second initiative is the start of a new thrombolysis service which will commence later this month. Where a stroke is caused by a blood clot, some patients may benefit from a drug designed to break down the clot and restore blood supply to the brain. This treatment must take place as soon as possible after a stroke and is only effective within the first 4.5 hours. This is one of the reasons why it’s important to ‘Act FAST’ and get to hospital as soon as possible if a stroke is suspected.

Act FAST:

• Face – Has their face fallen on one side? Can they smile?
• Arms – Can they raise both arms and keep them there?
• Speech – Is their speech slurred?
• Time – Call 999 if you see any single one of these signs.

Minister for Health and Social Care, Howard Quayle MHK, said: “I welcome the findings from Professor Rudd and his colleagues. We are fortunate to have had such an eminent team of stroke care professionals visit our Island.

“This is a further example of how we continuously work to review and develop care and treatment within the Island’s health service. It also demonstrates our commitment to develop the care pathway on the Island for stroke patients.

“Best practice has evolved and it is clear that patient care and safety is best served by a fully integrated stroke service that sees patients treated in a single ward from admission through to discharge by a multidisciplinary team.

“The main focus is on delivering ever better care for patients, and that is what these two initiatives seek to do.”

The report by Professor Rudd and his team also highlighted the work of Consultant Physician Dr John Tomas in developing stroke services over the past several years. In addition the team were particularly impressed with the skills, enthusiasm and vision of Gillian Horsey, Stroke Specialist Nurse.

The team included a Consultant Stroke Nurse, Dr Gill Cluckie, which was beneficial as the Island’s five year strategy aims to create a similar post to lead the Island’s Stroke Service.