Proposal for Stroke services
Access to specialist emergency services, such as stroke care, should be via your local (or nearest) A&E, where you would be treated and, if needed, transferred to a specialist team, which may be in a different hospital.
Our proposal to improve stroke care is an example a proposed change based on this principle.
A stroke is a brain attack, which happens when the blood supply to your brain is cut off. For 85% of cases this is because of a blood clot. In around 15% of cases this is because of a burst blood vessel causing a brain haemorrhage.
Our stroke services compare well with the best in many ways, but we could do better. We know from significant national and international evidence that patients who are treated in a highly specialised, specialist stroke unit in the first 72 hour period following a stroke, have better chances of survival and making a good recovery.
Clinical evidence shows that fast action prevents the brain damage caused by a stroke. If this is followed by a short period of the highest dependency care provided by a team of specialist doctors, nurses, therapists and technicians, then people could avoid long lasting debilitating effects.
None of our three hospitals currently has the right number of specialists to provide the level of specialist stroke unit that we are proposing.
By joining together our stroke teams across the three hospitals, we could provide a specialist stroke unit to lead the network of stroke services, and continue to provide stroke care at each of our three hospitals.
The proposed changes
- We propose to develop a specialist stroke unit at Basildon Hospital. The reason for choosing Basildon is that high dependency stroke services should have close links with the specialist skills of the existing cardiothoracic centre for heart and lung problems.
- The local A&E team would be equipped and able to diagnose and stabilise your condition and initiate treatment. Advanced imaging and initial treatment for the majority of strokes would continue to be available at each local A&E. Most strokes (around 85%) are as a result of a blood clot blocking the flow of blood to the brain and some can be treated with drugs to dissolve the clot – a treatment known as thrombolysis.
What this means:
- If it were suspected you were having a stroke, you would be taken by ambulance to the nearest hospital. Following a diagnosis in A&E, you would start the thrombolysis treatment, if appropriate, before going by rapid transfer to the specialist stroke unit in Basildon.
- If your stroke were due to a bleed in the brain (which affects around 15% of cases), you would be transferred immediately for treatment either at Basildon, if appropriate, or to a higher specialised centre in Cambridge or Queen’s Hospital in Romford, which is what happens now.
- Your stay in the specialist stroke unit would be up to 72 hours, after which you would either go home, if you made a good recovery, or return to your local hospital for further rehabilitation.
- The specialist stroke unit team would provide a clear plan to support your recovery, including physiotherapist support and speech and language therapy.
We would like to know your views on this overall approach and on
specific proposals for the development of specialist stroke care to be provided by the specialist
stroke unit at Basildon Hospital, close to the existing heart and lung centre.