Agenda item

[To receive a presentation on stroke services at the RWT. The presentation slides are attached which will be explained in full by representatives from the Trust at the meeting]. 

The Group Manager of the Royal Wolverhampton NHS Trust introduced a report on Stroke Services at, The Royal Wolverhampton NHS Trust.   He gave a summary of the ongoing improvement work in Stroke Services.  The service had 39 beds, which were based at New Cross Hospital.  In April 2018 they had merged with Walsall’s Stroke Provision providing hyper acute and the acute aspects of stroke care.  The rehabilitation aspects were retained at Walsall on a well-established stroke pathway.  There were four hyper acute

beds on the unit.

The Group Manager commented that the biggest challenge with the merger was staffing.  They were now at the point where staffing levels were appropriate.  He commented that there was an extensive data failure in the latest quarter’s information which was included with the agenda pack.  The metrics were significantly attributable to a failure of the Trust to record information accurately.  They had improved the data quality since this time.  He described the statistics in great detail.  An A Unit meant the service was doing very well, an E Unit corresponded to poor.  Extensive training was taking place on the ward.  The gold standard was to give a stroke patient a bed within 2 hours and there was a target of 4 hours.

The Group Manager stated that they had been looking at how they could improve the SMR (Standard Mortality Ratio Figures) for stroke patients.  Several external reviews had taken place, both at their request and those that were mandated.  Extensive work had taken place to improve medical notes.  They currently had an external Medical Consultant working on the ward, reviewing all the medical notes for RIP patients.  They were challenging themselves to see if there was anything they could have improved in a patients care.  

The Group Manager commented that in the third quarter, the SSNAP (Sentinel Stroke National Audit Programme) requirement was for a patient to see a suitably trained stroke nurse within 24 hours, the Trust in the previous week achieved it within less than 15 minutes.  The requirement for a Doctor Review was within 14 hours and in the previous week the Trust had achieved it within 30 minutes.  They often would have a nurse and a Doctor waiting in the Emergency Department for the patient to arrive.  They had established a middle tier of Doctors using the Trust’s Clinical Fellow Scheme, which had been hugely successful.  They currently had four Clinical Senior Fellows who would be training over the next two years to become Consultants.

The Stroke Consultant commented that she had started working as a Stroke Consultant at the Trust in 2012.  There had been numerous changes to the service in this timeframe.  Consultant numbers had vastly improved and there had been an increase in beds.  They now provided an overnight Stroke Consultant and so a Consultant was available 24 hours a day. 

Members asked some technical questions about the performance statistics to which the Group Manager gave a full explanation. 

A Panel Member commented that his personal experience of the Stroke Department at the RWT was a positive one.  The Medical Director commented that whilst there had been some staffing issues in the department, which were related to the merger, they were now almost all resolved.  He believed the Trust were providing an excellent stroke service.  He thanked all the teams for completing a very difficult job under sometimes difficult circumstances.  

Resolved: That the Stroke Services at RWT report be noted.