The number of people dying from strokes could be reduced by 30% by 2010 if a bold new health programme is successful.
The Stroke 90:10 initiative, launched in North West England, aims to significantly change frontline care practice and could potentially see an unprecedented level of stroke sufferers leaving hospital without serious disability in the region, if it meets its ambitious targets.
One of its pioneering aims is to ensure that all people receive a brain imaging CT scan within 24 hours of a suspected stroke. Currently, that rate stands at around 43% of people in the UK only.
Stroke 90:10 is being run in partnership with the Health Foundation, the Stroke Association and the Royal College of Physicians. It follows research by the Health Foundation last year which found that the UK lags behind other European and Western countries in dealing with strokes – currently the third biggest killer in the UK.
A total of 28 hospitals are taking part in the collaborative programme in the North West and aim to set the pace for the rest of the NHS working in parallel with the government which also recently introduced its own National Stroke Strategy. The first stage of the programme will be to gather data and to check that people with strokes are receiving essential and basic checks promptly on admission, such as weighing, aspirin, swallow tests and CT scans.
Speaking at the programme launch, Director of the Stroke Programme at the Royal College of Physicians Dr Anthony Rudd called for a culture change in the NHS. He said recent audits had ‘identified huge quality gaps’ in UK stroke care and a need for greater intervention. These gaps included findings that people were much less likely to receive CT scans if admitted at weekends or if they were older. ‘We have to stop managing strokes as though they occur between 9 and 5, Monday to Friday. We have to develop a proper 24-hour health service,’ he said. Dr Rudd said the timing of the programme was crucial. ‘If we don’t get this right over the next 2 or 3 years, the opportunity will completely disappear. There is this window of opportunity now and it will go off the agenda.’
Programme leader Dr Maxine Power, Director Quality Improvement at Salford Royal NHS Foundation Trust and a former Health Foundation Quality Improvement Fellow agreed it was timely and said objectives were achievable. She told the launch, attended by 14 participating hospitals from across the North West: ‘I think this collaborative is important because it is the ‘right thing to do’. It is unacceptable that patients who experience stroke are not guaranteed to receive all the care we know they should receive in a timely and efficient way. The collaborative is a model which brings teams together to learn and move fast towards a common goal – in this case to achieve a score of 90 or greater on the sentinel audit in 2010’.
Dr Power also supported patient representatives’ calls at the launch for better psychological care for stroke sufferers. She stressed the need to ‘listen to patient stories’ and experiences of their treatment. Saying there is a danger of NHS staff becoming distracted by the technical rather than the humane in the strive to improve quality.
Former hotelier Dean Tarleton, a stroke patient representative at Southport and Ormskirk Hospital NHS Trust, said there was a real need for more psychological and emotional support for stroke victims because of the impact on all aspects of their lives. ‘When you are at the hospital you are told when and what to eat and so on. But when you get home it hits you like a bus,’ he said.
The programme was launched in January and will be in two stages; it will include a control with half the hospitals taking part in the first stage. Stage two will take place a year later with the other hospitals then taking part and working together in learning sets to accelerate the rate of progress.
Dale Webb, Assistant Director of Quality and Performance Analysis at the Health Foundation said: ‘We know from the national stroke audits that there are many deficiencies in stroke care across the UK. The recent stroke strategy for England has provided new momentum to improve stroke care. However, we believe that we can accelerate the pace of change even further by bringing hospitals together to learn from each other, to identify problems in care and test new solutions. The North West has set the ambitious target of achieving a score of 90 out of 100 on the next national stroke audit in 2010 and the Health Foundation thinks this collaborative approach will help the region reach unprecedented levels of stroke care’.