Optimising care pathways for acute stroke and transient ischaemic attack

The project aimed to improve the quality of urgent care for strokes by implementing best practice. It did this through the development and implementation of an integrated hyper-acute pathway for strokes and transient ischaemic attacks (TIAs). It also developed an innovative best practice TIA service, including the promotion of secondary care prevention and self-care.

Key findings

• There has been a generally upward trend both in the number of patients being thrombolysed and the speed with which treatment is delivered.
• Reduced variance in TIA pathway for high-risk patients.
• Reduced number of patients with incorrect paperwork at TIA clinic.

Challenges

• Staff leaving the project and needing to be replaced led to progress delays and disruption to continuity.
• NHS reorganisations taking place during the project led to approvals needing to be sought twice.
• Clinician availability presented challenges and sometimes the project was mis-perceived as an outside demand rather than a collective, facilitative process.
• The team struggled to engage with hard to reach groups, though they succeeded in delivering awareness raising sessions to three different Black and Minority Ethnic (BME) groups.
• There was difficulty in accessing training time with GPs.

Who was involved?

The project was led by Dr Anthony Kenton, Consultant Neurologist at University Hospital Coventry. It was run by a network of two primary care trusts, three acute hospital trusts and the Ambulance Service, along with user organisations and academic expertise in Coventry and Warwickshire.