Improving care for stroke patients in South Yorkshire

Hospitals in South Yorkshire are being urged to treat stroke as a medical emergency at all times in order to improve patient care.

A unique project conducted by researchers from the University of Sheffield, Sheffield Teaching Hospital (STH) and Collaboration for Leadership in Applied Health Research and Care for South Yorkshire (CLAHRC SY) investigated ways to improve care for stroke patients across the county.

Improving patient careFindings from the Improving Stroke Unit Quality Project highlighted the desperate need for stroke to be treated as a medical emergency, just like heart attacks, and for more comprehensive education to raise awareness about the signs of stroke.

Amanda Jones, Stroke Nurse Consultant at Sheffield Teaching Hospitals NHS Foundation Trust, said: "If someone suspects that they have had a stroke it is vital that they get to hospital immediately as every minute nearly two million neurones die.

"Early assessment can ensure those who are appropriate for clot-busting therapy receive it, and the sooner the treatment is given the better. Early treatment can make the difference between someone being disabled and dependant on others for basic every day activities to being able to be completely independent.

"Not everyone will be eligible for clot busting treatment but getting to hospital as quickly as possible will ensure that specialist treatments and rehabilitation starts as soon as possible which will have a major impact on a person’s life.”

In total 59 stroke survivors, relatives and their carers, and 66 members of staff working on stroke units across South Yorkshire, including Barnsley, Sheffield, Rotherham and Doncaster, took part in extensive interviews and focus groups to determine the top priorities for improvement.

The project, which was funded by Sheffield Hospitals Charitable Fund via the CLAHRC SY, will play a significant role in shaping stroke services for the future.

Dr Tony Ryan, Senior Lecturer at the University's School of Nursing and Midwifery, said: "Importantly the work relies heavily upon the views and experiences of people who have had a stroke, as well as their family caregivers and frontline clinical staff.

"By using these experiences as the basis for change the project is ensuring that services in South Yorkshire develop in a way which is consistent with the needs and wishes of the people who are close to these vital services."

In the past stroke was perceived to be an inevitable risk of growing older, with little that could be done other than to make people comfortable. In recent years there have been considerable advances in medicine and technology, and improvements in how stroke services are organised.

Patients are now treated in specialist stroke units rather than on general medicine wards, and there is much more emphasis on getting patients into hospital quickly and treating them immediately. In England these changes have been guided by the National Stroke Strategy, a Department of Health policy published in 2007, which sets out the gold standard for stroke care.

Barbara Rosario, Consultant Geriatrician at Sheffield Teaching Hospitals NHS Foundation Trust, said: "Remarkable improvements can be seen in those people who have a stroke and receive a treatment to unblock their arteries.

Act F.A.S.T

The main stroke symptoms can be remembered with the word FAST: Face-Arms-Speech-Time.

Face – the face may have dropped on one side, the person may not be able to smile or their mouth or eye may have drooped
Arms – the person with suspected stroke may not be able to lift one or both arms and keep them there because of arm weakness or numbness
Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake
Time – it is time to dial 999 immediately if you see any of these signs or symptoms

"However the key to success is starting the treatment as early as possible and it is essential that people call an ambulance at the first signs of stroke such as face, arm or leg weakness or speech difficulty.”

Results from the Improving Stroke Unit Quality Project showed that many staff were very proud of the service they provided and many patients and carers praised the good quality of care they received.

However, a number of areas which would benefit from improvement were identified including: improved communication between staff and patients, and staff and other staff, improved psychological support, more rehabilitation to meet individual needs, more stroke specific community services to enable timely discharge and more support for carers from staff.

A briefing paper on Improving Stroke Unit Quality has been produced, and CLAHRC SY is now working closely with some of the stroke units involved to develop ways to improve aspects of care in line with the priorities that have been identified.

Additional information

Improving Stroke Unit Quality
For more information about the project please contact: Madeleine Harrison, Stroke Unit Quality Researcher, 0114 2225424, madeleine.harrison@sth.nhs.uk

To view the Improving Stroke Unit Quality briefing paper visit CLAHRC

UK Stroke Association
To find out more about stroke and to learn about the wide range of support and advice available visit UK Stroke Association

Sheffield Teaching Hospitals
Sheffield Teaching Hospitals is the UK's largest NHS Foundation Trust and one of the largest and busiest teaching hospital trusts. It cares for over a million patients each year across five hospitals and a variety of community venues around the city:
• Weston Park Cancer Hospital
• The Royal Hallamshire Hospital
• The Northern General Hospital
• Charles Clifford Dental Hospital
• Jessop Wing Maternity Hospital

It offers a full range of local hospital and community services for people in Sheffield as well as specialist services to patients from further afield. The Trust is recognised internationally for its work in neurosciences, spinal injuries, cancer, transplantation, neurosciences and orthopaedics. It is one of only a handful of hospital Trusts to have been awarded the highest rating of 'excellent' for both the quality of services and financial management, three years running.

The University of Sheffield
With nearly 25,000 students from 125 countries, the University of Sheffield is one of the UK’s leading and largest universities. A member of the Russell Group, it has a reputation for world-class teaching and research excellence across a wide range of disciplines. The University of Sheffield was named University of the Year in the Times Higher Education Awards 2011 for its exceptional performance in research, teaching, access and business performance. In addition, the University has won four Queen’s Anniversary Prizes (1998, 2000, 2002, and 2007).

These prestigious awards recognise outstanding contributions by universities and colleges to the United Kingdom’s intellectual, economic, cultural and social life. Sheffield also boasts five Nobel Prize winners among former staff and students and many of its alumni have gone on to hold positions of great responsibility and influence around the world. The University’s research partners and clients include Boeing, Rolls-Royce, Unilever, Boots, AstraZeneca, GSK, ICI, Slazenger, and many more household names, as well as UK and overseas government agencies and charitable foundations.

The University has well-established partnerships with a number of universities and major corporations, both in the UK and abroad. Its partnership with Leeds and York Universities in the White Rose Consortium has a combined research power greater than that of either Oxford or Cambridge.

Contact

Amy Pullan
Media Relations Officer
The University of Sheffield
0114 222 9859
a.l.pullan@sheffield.ac.uk