Cwestiwn ysgrifenedig WQ89268

Guided by our Stroke Quality Statement, work is being undertaken across Wales to improve access to stroke services and outcomes for people affected by stroke. A national stroke programme team ,led by the National Clinical Lead for Stroke, is supporting health boards to drive improvement in outcomes for people affected by stroke through regional operational delivery networks (ODN). The North Wales ODN is fully engaged with the national stroke programme team.

The comprehensive stroke centre (CRSC) model is the optimal model for stroke care in Wales. Newly-launched stroke guidelines from the Royal College of Physicians call for stroke care to be organised in this regional way, and this is strongly supported by Welsh Government, Welsh clinicians, and the Stroke Association in Wales. Where this model has been adopted in other areas of the UK, significant improvement in outcomes across the stroke pathway have been achieved.

Each CRSC will become the focal point for clinical expertise, and for the delivery of interventions, such as mechanical thrombectomy and intensive rehabilitation in the first critical 72-hour hyper-acute phase following a stroke. Following this phase of care, people will be transferred to local hospital and community stroke services to continue their ongoing recovery and rehabilitation closer to home.

To ensure equitable access to thrombectomy, the Welsh Health Specialist Services Committee commissions access to thrombectomy from two English NHS Trusts; The Walton Centre in Liverpool and North Bristol NHS Trust.

A national thrombectomy oversight group meets every two to three months, seeking opportunities for improvement, and supports new innovations to improve the existing thrombectomy pathway, including:

• The deployment of artificial intelligence in radiology departments to accelerate diagnosis of stroke, enhance clinical decision making and reduce onward pathway delays.

• Pre-hospital virtual triage is being piloted in Cardiff and Vale University Health Board which will enable patients to be taken straight from the ambulance to a CT scan. Early indications are that this is demonstrating promising outcomes and the national stroke programme team is exploring opportunities to spread this.

• Since March 2022, inter-hospital transfers for thrombectomy are classified as a ‘category red transfer’ – the most urgent response. Wales is the first nation to have a ‘red’ inter-hospital transfer arrangement.

All health boards provide rehabilitation as an integral part of their stroke services, and continue to develop early supported discharge, which provides essential rehabilitation to enable people to recover at home. We make £1.4m available for community-based multi-professional rehabilitation support workers for all, including those at risk of losing their independence. This is supported by our Allied Health Professions Framework Programme and the All Wales Rehabilitation Framework. Health boards, local authority and third sector partners are using the Framework to plan rehabilitation services to respond to the needs of their populations.