Agenda item

Report and Presentation by Director of Commissioning Strategy and Delivery

The Director of Commissioning, Strategy and Delivery gave a PowerPoint presentation to Members on the review of stroke rehabilitation services in County Durham and Darlington and in doing so outlined the vision and scope of the review, which focussed on the rehabilitation element of the stroke pathway following discharge from acute care.

Members were informed that the current service, a single site based at the University Hospital North Durham (UHND) came about following a consultation process in 2011; that the quality and performance of the stroke pathway at the point of emergency had improved significantly but that the outcome of patients in respect of the rehabilitation element was under performing; and that the current model for acute stroke rehabilitation was spread across two sites, UHND and Bishop Auckland Hospital (BAH), creating workforce pressures.

It was stated that there were two phases of consultation with patients and carers to gather experience and feedback, undertaken by the Clinical Commissioning Group and Stroke Association; the national team from the Getting It Right First Time programme identified a number of recommendations relating to therapy and consultation cover; and an options appraisal was undertaken to identify a future model for the service.

Members were advised that the proposed future model was based on four key areas, those being effective screening and prevention, appropriate and timely hospital care, seamless care delivered closer to home and integrated long term care; and that the preferred option was to consolidate acute rehabilitation onto the Specialist Stroke Unit at UHND with a robust and effective community based rehabilitation in place.

Members were advised that a consultation exercise would be undertaken from 7 October for 12 weeks and the outcome of the consultation would be considered by Clinical Commissioning Groups and the Trust in the new year.

Discussion ensued on the ‘golden hour’ following a stroke and how residents in rural areas were managed. It was confirmed that for an acute stroke, a patient would need to be seen within 4.5 hours in order to receive clot busting drugs, and the best outcome for a patient would be when seen within a 90 minute window. The Trust worked closely with North East Ambulance Service to ensure patients were transported promptly to UHND, and in some cases patients had been transferred to Newcastle in time for a thrombectomy.

Members queried the sustainability of a therapist in the community and were assured that due to consolidation of teams, resources would be available to be reinvested in the employment of additional therapists.

RESOLVED – That the Director of Commissioning, Strategy and Delivery be thanked for the presentation and the content be noted.