Final report on research into re-organising hospital stroke care published

The region has been part of an NIHR research study investigating the impacts of re-organising hospital stroke services in different parts of the country. A final report has now been published:

“Evaluation of reconfigurations of acute stroke services in different regions of England and lessons for implementation: a mixed-methods study” 

You can download the report and find out more here.

In summary, the research showed:

Stroke patients do better if they get the right care at the right time, but getting good stroke care varies depending on where people live and the hospital at which patients are treated. In 2007, the Department of Health and Social Care proposed that having specialist Stroke Units in fewer hospitals (called ‘centralisation’) might improve the chances of patients getting the right care more quickly.

When efforts to centralise hospital stroke services in London, Greater Manchester, and the Midlands and East of England were studied in terms of the following:

  • how centralisation affected numbers of patient deaths, quality of care provided, patient and carer experience and value for money (in areas where changes were implemented)
  • how changes were put into action, whether or not they kept going and what factors made a difference.

It was found that if all patients went to a specialist unit for stroke, there were fewer deaths than if some patients went to units that were not specialist. Centralising stroke services led to fewer patient deaths, less time spent in hospital, provision of better care and overall good patient experiences. It also provided value for money.

Putting a centralised service in place depended on region-wide leadership, working together with health professionals, to achieve changes. Local stroke networks helped make change happen within hospitals. Centralisations that linked achievement of quality standards with payments were more likely to have the resources to provide the right care. NHS reforms in 2013 removed region-wide leadership and local networks, making it harder to centralise stroke services.

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