GIRFT’s review of stroke services in England found that acute stroke care is delivered in 107 units across England, each managing an average caseload of around 650 acute stroke spells per year.
The national report for stroke makes a series of 29 recommendations for improvements in service delivery and patient care, based on the largest and most comprehensive specialty data set that has ever been assembled.
Among them are measures to improve access and time to thrombectomy (a procedure used to restore blood flow to affected brain tissue which can reduce the severity of disability caused by an ischaemic stroke), as well as improving the speed and effectiveness of scanning and diagnosis of stroke by adopting the National Optimal Stroke Imaging Pathway (NOSIP).
Dr David Hargroves
Clinical Lead for Stroke
David is a consultant and clinical lead for stroke medicine at East Kent Hospitals University Foundation Trust. He has been a consultant in East Kent for over ten years and clinical lead for stroke medicine at the trust for the past nine years, personally assessing, imaging and treating over 4,500 patients with transient neurological deficit with same day MRI / CEMRA and a similar number of patients with persistent neurological deficit.
His East Kent team recently won the national award for best Quality Improvement Initiative at the HSJ Patient Safety Awards 2022, for their work in delivering sustainable, patient centred improvements, during the COVID pandemic, using innovative technological solutions aligned to the GIRFT national report recommendations.
David chairs the IV Stroke Thrombolysis governance meeting and has reviewed the clinical histories and neuroradiology for over 1,200 cases treated in East Kent.
David has been local principal investigator for several international clinical trials and has a particular research interest in use of advanced imaging in hyper acute stroke care, obstructive sleep apnoea and neurovascular disease, telemedicine use in stroke care and medication compliance and adherence in patients with neurovascular disease.
He was elected to the British Association of Stroke Physicians’ education and training board in October 2011 and was chair of the group from 2013 until 2017, remaining an active co-opted member.
David won the prestigious 2017 Life after Stroke Award for Professional Excellence from the Stroke Association.
Dr Deborah Lowe
Senior Clinical Advisor for Stroke
Dr Deb Lowe is a consultant stroke physician and geriatrician on the Wirral. In 2020, she was announced as the NHS National Clinical Director for stroke.
She graduated from Liverpool Medical School in 1997 and did her postgraduate medical training within Merseyside and Cheshire region. She completed a research fellows post in stroke medicine and has an interest in patient education and empowerment.
She has been a consultant stroke physician and geriatrician at Wirral University Teaching Hospital NHS Foundation Trust since January 2006. Since 2008 she has been a clinical service lead for stroke, elderly care and rehabilitation and clinical director for division of medicine & acute specialties since 2013.
During her time in medical management she has developed several services and Wirral Stroke Service is recognised as being one of the best performing in the UK in national audits. She has also developed one of the first older persons short stay and frailty units in the region. Deb’s work in stroke was recognised nationally when she was a finalist in the Stroke Association Life After Stroke Awards for Professional Excellence in 2013.
Deb has been clinical lead for Stroke within the Strategic Clinical Networks and Senate since January 2014. She has led peer support service reviews across the region over the last few years and has comprehensive knowledge of stroke services across country.
She chairs several stroke boards that have focused on the delivery of sustainable and effective stroke services. Within this role she is keen to promote a culture of effective clinical engagement, accurate performance monitoring and is currently working closely with clinical leads and commissioners across the north-west coast to deliver sustainable world class stroke services.
She delivers education both within primary and secondary care to improve knowledge and understanding of stroke and, most importantly, the management of atrial fibrillation and other modifiable risk factors.
Mechanical thrombectomy (MT) delivery in England: This 2023 draft report summarises a quality review programme focused on the delivery of MT interventions across England, drawing together evidence and best practice from a national programme of events working with all Comprehensive Stroke Centres (CSCs), Acute Stroke Centres (ASCs) and supporting services involved in the delivery of MT. The aim is to support local and regional services build referral pathways and processes that can sustain rapid growth in MT volumes and are effective in ensuring all suitable patients get rapid access to MT.
National Clinical Guideline for Stroke: The National Clinical Guideline for Stroke provides evidence-based practice guidance to improve the quality of care for stroke patients. It is aimed at nurses, doctors, therapists and care staff, as well as patients and their families/carers, and those commissioning stroke services. The 2023 edition is now available.
Work on artificial intelligence (AI): The GIRFT stroke team has been working closely with NICE and the AI in Health and Care Award (an NHS AI Lab programme run by the Accelerated Access Collaborative in partnership with the National Institute for Health Research (NIHR)) to deliver guidance on the use of AI as a decision support tool for clinicians interpreting brain scans in patients suspected of suffering a stroke.
More information > Artificial intelligence revolutionising NHS stroke care and NICE guidelines Artificial intelligence (AI) software to help clinical decision making in stroke
Developing leadership in stroke services: GIRFT is supporting the Royal College of Physicians in the launch of a new multi-professional leadership programme aiming to grow and sustain leadership across NHS stroke services in England. The year-long GIRFT stroke leadership academy (stroke specific) programme will serve as a means of fulfilling a key recommendation from the GIRFT national report for stroke (2022). Applications close on 10th February 2023.
Collaboration on NHS RightCare stroke toolkit: GIRFT has worked in partnership with RightCare and the National Stroke Programme on a toolkit highlighting the priorities for stroke prevention, identification, acute care, and rehabilitation, to support Integrated Stroke Delivery Networks (ISDNs) to understand the priorities in stroke care along the whole stroke pathway. More information.
Collaboration on guidance for CVD prevention: The GIRFT stroke team collaborated with Oxford Academic Health Science Network (AHSN) on a series of practical guides to help both primary care teams and integrated care systems continue to deliver quality cardiovascular disease (CVD) prevention services during and after COVID-19:
- CVD prevention guide for primary care
- CVD prevention guide for systems
- Targeted AF detection in COVID-19 vaccination clinics
COVID-19 stroke guidance: Two guides for teams delivering stroke services during and after the COVID-19 pandemic were made available in a collaboration between GIRFT and Oxford AHSN.
GIRFT report for stroke offers a blueprint for improvements to benefit patients, staff and the wider NHS
Speeding up access to imaging for people suspected of stroke and ensuring more stroke patients receive treatment to reduce the chance of life-changing disability are among the key measures outlined in a new national report from the Getting It Right First Time (GIRFT) programme.
The national report for stroke makes a series of 29 recommendations for improvements in service delivery and patient care, based on the largest and most comprehensive specialty data set that has ever been assembled for stroke services in England.
Improving the speed and effectiveness of scanning and diagnosis of stroke by adopting the National Optimal Stroke Imaging Pathway (NOSIP), with treatment provided by an appropriately skilled workforce as part of an integrated pathway, could help to reduce the average length of time patients with a stroke stay in hospital.
Watch the video about the Stroke report…
Click above to play the Stroke national report video