Stroke service review What is a stroke? A stroke is a life-threatening medical condition which occurs when the blood supply to part of the brain is cut off. Strokes are a medical emergency and urgent treatment is essential. Strokes are usually treated with medication, including medicines to prevent and dissolve blood clots, reduce blood pressure and reduce cholesterol levels. Procedures may be required to remove blood clots. Surgery may also be required to treat brain swelling and reduce the risk of further bleeding in cases of haemorrhagic strokes.

What is a service review?

A service review involves examining a service area thoroughly to understand which parts of the service are working well and which are not working as well, to find ways to improve the service further for the good of the patient. This may involve looking at department policies and processes, data analysis, speaking often and regularly to the people who use the service and the doctors and nurses who provide them. Once all this information has been gathered, it is used by managers of the service to help them make a plan for improvement.

Stroke services in the Humber region

Stroke services are provided at three of the main hospitals in the Humber region: Hull Royal Infirmary, Scunthorpe General Hospital and Diana Princess of Wales Hospital in Grimsby. Hull Royal Infirmary and Scunthorpe General Hospital have hyperacute stroke units, where patients receive intensive care following the onset of stroke.

Acute stroke units at Hull, Scunthorpe and Grimsby provide the next step of stroke care (post-hyperacute care) which includes further investigation into the cause of the stroke and a treatment plan for recovery. Rehabilitation and follow-up care after discharge is provided at Hull Royal Infirmary, Scunthorpe General Hospital, Diana Princess of Wales Hospital in Grimsby and Goole and District Hospital.

Why do we need to review hospital services in the Humber region?

Advances in medical knowledge and technology have allowed our doctors to develop fantastic services for our hospitals, which, in part, is helping people live longer and survive illnesses that their parents or grandparents might not have. These developments have also enabled more healthcare services to be provided away from hospitals — at GP practices and in the community, for example — while hospitals continue to focus on looking after the most seriously ill patients.

As the ways of delivering care to patients change, an extensive hospital services review is needed to ensure we provide services that are safe and patient-centred, both now and in the future. NHS services need to constantly adapt to provide the best possible care for patients with the resources available. Current challenges, such as rising demand, workforce challenges, finance and quality of care mean that change is necessary to ensure the future of our health services.

Stroke service review

What happens to stroke patients in the Humber region?

John is taken by ambulance to Hull Royal Infirmary (or Scunthorpe General Hospital) after suffering from a suspected stroke. He is taken to the hospital’s A&E department from where he would go straight to the hospital’s hyperacute stroke unit for the best possible treatment available.

John undergoes tests to confirm he has had a stroke and to discover more information which will ensure he receives the right emergency treatment. John has a brain scan as soon as possible (a CT scan, MRI scan or both) and is given aspirin (unless his scan shows that he has suffered brain bleeding). He may be given a treatment called thrombolysis if a blood clot caused his stroke.

John may then undergo further tests to identify why he had a stroke and to determine which treatments he needs to prevent a further stroke. These might include: blood tests, tests to detect high blood pressure, or a test to check for narrowing of arteries in his neck. In the stroke unit, John will be assessed by one or more members of the stroke team, which includes occupational therapists, physiotherapists, speech and language therapists, pharmacists, ophthalmologists, clinical psychologists and dieticians, depending on the problems John is experiencing.

John’s rehabilitation begins in hospital and continues after he is well enough to go home. When John is well enough to leave hospital, the stroke team produces a discharge plan to make sure all the support from health and social services is in place before he goes home. John’s local council could make arrangements for any practical assistance he might need at home, such as carers visiting his home to help him with day-to-day activities. Community nursing teams and other therapists will provide care and support for John’s rehabilitation in his local community.

Have your say

Throughout the review process we are keen to hear from members of the public to ensure their feedback and experiences are reflected in any recommendations made. You can do this in a number of ways:

Email us: humber.acutereview@nhs.net

Phone us: 01482 344711

Write to us: Humber Acute Services Review, c/o NHS Hull CCG, 2nd floor, Wilberforce Court, Alfred Gelder Street, Hull, HU1 1UY

Find out more about the review at humbercoastandvale.org.uk/humberacutereview