The NHS Long Term Plan outlines how Health Education England will work with partners to improve stroke care along the full pathway from symptom onset to ongoing care. Meeting the ambitions in the Long Term Plan would result in the NHS having the best performance in Europe for people with stroke. This work includes prevention, treatment and rehabilitation.
A stroke is a serious life-threatening medical condition that occurs when the blood supply to part of the brain is cut off. The damage this causes can affect the way our body works, as well as how you think, feel and communicate. A preventable disease, it is the 4th single leading cause of death in the UK and the single largest cause of complex disability.
The 2017 Commonwealth Fund healthcare outcomes ranking placed the UK 10th out of 11 due to poor cardiovascular (CVD) scores on stroke mortality amenable to healthcare. Without action, the number of people having a stroke will increase by almost half, and the number of stroke survivors living with a disability will increase by a third by 2035.
Thrombolysis rates are currently only 11% and could benefit up to 20% of stoke patients. On average, one patient thrombolysed would save the NHS £47,000 over 5 years. Mechanical thrombectomy increases the proportion of people who could function independently at 90 days following stroke by between 19-35%. Current thrombectomy rates are 1%, when up to 10% could benefit.
Lack of access to post-acute rehabilitation is where the least progress has been made over the last 10 years. Less than a third of stroke survivors receive a review of their progress and unmet needs at six months post stroke. A whole system workforce approach is needed to address the skills and capability for stroke prevention and detection; hyper-acute stroke services; specialist assessment and rehabilitation; and life after stroke.
We are working closely with system partners and stakeholders to deliver improvements along the entire patient pathway for stroke services. This includes:
- Working with the Stroke Specific Education Framework (SSEF) team, developing a review of the skills and capabilities required for the entire workforce for safe stroke care including those in existing roles and allowing the development of additional roles through UK wide engagement. Access the freely available SSEF Online Toolkit by clicking here.
- Developing a multi-professional repository of freely available training resources, the Stroke Training Guide, that can be used simultaneously with the SSEF to support workforce upskilling, training and development. A digital version of this guide, the Stroke Toolkit, is available on elfh.
- Developing the Stroke elearning programme to promote better patient care by providing all health and social care professionals and multidisciplinary teams with the appropriate level of knowledge, skills and experience they need to deliver effective stroke prevention and care to people with stroke, and at risk of stroke.
- Working with NHS England and NHS Improvement (NHSE/I) in the expanding delivery of Mechanical Thrombectomy, through representation on the Thrombectomy Implementation Group, providing support to the development of interventional workforce training.
- Working at a local level through the Integrated Stroke Delivery Networks (ISDNs) to enable workforce transformation and development using the HEE Star tool to address workforce challenges that emerge on stroke care and enabling the cross / upskilling of the workforce through training resources.