Award winning collaboration improving stroke thrombolysis delivery across the South West

Stroke is the third biggest killer and the main cause of adult disability in the UK today. Timely stroke thrombolysis is essential to minimise damage to the brain caused by a stroke. Across the South West, the established Stroke Networks in the Peninsula and Avon, Gloucestershire, Wiltshire and Somerset have had a history of working collaboratively, sharing good practice and supporting each other in enabling better participation in research. Stroke clinical networks have had an instrumental role in increasing the number of patients receiving thrombolysis by reducing delays in their treatment, thus reducing deaths and disability from stroke

The work of the South West Peninsula Cardiac and Stroke Network and Peninsula CLAHRC using computer simulation and data analysis to model patient pathways and identify improvements at the Royal Devon and Exeter Hospital recently won the Exeter Impact Regional Partnership Award. This partnership working has led to a four-fold increase in stroke patients treated, and halved the time taken to deliver thrombolysis.

The modelling predicted that achieving an 8 minute reduction in door to needle times for thrombolysis could lead to better outcomes for patients. Working on this premise and identifying that reductions in door to brain scan times could be the key to achieving this time saving, the acute trusts in Avon, Gloucestershire, Wiltshire and Somerset have developed the Stroke 90 project. Seven hospital trusts have worked with ambulance colleagues to minimise delays in treatment by streamlining the process of delivering patients directly to CT scanning in preparation for thrombolysis. The Journal for Emergency Medicine recently published an article showing the significant impact of this collaboration.

In April 2013 the two South West heart and stroke networks joined to form the South West Cardiovascular Strategic Clinical Network, with new responsibilities for kidney disease and diabetes. Preventing strokes and improving the care and treatment of stroke when it occurs remain a major priority for the newly enlarged Network, working with acute and community trusts across the South West and in conjunction with the new GP-led clinical commissioning groups. The Network will be pressing on with further improvements in acute stroke treatments, including emergency thrombolysis, and spreading the learning from their award-winning earlier work so that more people with stroke benefit from the new advances in treatment.