3 July 2023

NHS 75: Stroke Service over the years

Dr. Amanda Jones, Consultant Stroke Nurse and Clinical Lead for the Stroke Pathway, Sheffield Teaching Hospitals NHS Foundation Trust, talks us through how Stroke Services have advanced over the years. Amanda said:

“Stroke can affect anyone at any time including children, young adults, middle aged people, older people and even babies.

Stroke care has changed dramatically since the inception of the NHS. Many years ago there was little that could really be done in terms of treatment and with no dedicated stroke units, patients were cared for by non-specialist staff usually on general medical wards.

Stroke Rehabilitation Units began to be developed in the 1980s. This meant that patients who suffered a stroke could receive coordinated Stroke Rehabilitation from a specialist team. I had the honour of working at the then new Stroke Rehabilitation Unit at Nether Edge Hospital which really opened my eyes to what could be achieved with well organised specialist multi-disciplinary care, but unfortunately the availability of stroke units at that time around the country was patchy.

In 2012, a new national data base called the Sentinel Stroke National Audit Programme (SSNAP) was developed - ensuring all stroke services are continually audited against national standards. This really helped drive further improvements and we now have Hyper Acute Stroke Units like the one I work at here at the Royal Hallamshire Hospital, where patients receive the first specialist assessments and treatment. We then have acute stroke services for continued medical support, stroke rehabilitation units and community stroke teams who deliver specialist rehabilitation in the more realistic setting of the stroke patient’s own home.

Over the past 15 years clot busting and more recently clot removal interventions have been initiated, with Sheffield Teaching Hospitals NHS Foundation Trust being at the cutting edge of their development. These treatments have not only saved the lives of many stroke patients but have also dramatically reduced potential disability.

2019 saw the development of regional stroke networks ensuring that all patients irrespective of where they lived would have access to Hyper acute specialist stroke assessment and treatment. Sheffield Teaching Hospitals is one of the national comprehensive stroke centres, Sheffield supports hospitals in our region such as Rotherham and Barnsley who do not have hyper acute stroke units, to ensure stroke patients have access to immediate specialist treatment wherever they live.

Other developments have been around TIA (mini strokes) with daily one stop clinics and timely treatment, which have had a significant positive impact.

With the 6th evidence-based stroke guidelines produced in April this year, stroke care and treatment will continue to develop and improve, and more lives will be saved. We will ensure that patients and their families have a good quality of life after their stroke with new guidance in rehabilitation supporting self-management and providing longer term stroke support, and also around workforce (which is a key requisite in delivering excellent stroke care) this will make a huge impact on the lives of stroke survivors and their families in the future.”


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