Decision details

The Chair welcomed Gemma Stanion, Programme Director and Programme Team Member, Healthier Lancashire and South Cumbria and Elaine Day, representing NHS England. 

The report presented provided an update on the current position within Lancashire and South Cumbria and outlined, at a high level, the work which was being progressed and the key decisions which would need to be made during the coming months of the programme.

In response to questions raised by members, the following information was clarified:

·  It was noted that stroke was not an older person's disease and that disabilities were lifelong. Stroke was the fourth major cause of death and the principal cause of disability in the UK. The Committee was informed that lifestyle was a major contributing factor. On how the council and the NHS could work together to improve lifestyles, it was noted that a strategy was in place across NHS providers including GPs and the NHS Clinical Commissioning Groups to prevent strokes through education and training regarding lifestyle choices in communities.  This was also embedded in GP contracts.  It was acknowledged, however, that regardless of intervention, incidences of stroke continued to rise and timely services were essential to mitigate the long term impact on public health. 

• In noting that a considerable number of patients were not being appropriately treated for Atrial Fibrillation and hypertension, it was explained that approximately 30% of patients were discharged from hospital with no plan. 
• With regard to access to support for patients and carers post-stroke and the pressures on local authority budgets increasing inequity for these services, assurance was sought that the programme would review life after stroke support with councils and not just with the Stroke Association. It was confirmed that only some district councils provided life after stroke classes. It was hoped that a report would be presented in March 2019, asking those district councils to enable provision.

·  The findings of all the engagement sessions with Stroke Association Groups and staff would be shared with the Committee.

·  Members sought assurance on the ambulatory model and asked what had been learned from the pilot and how this would be embedded across the footprint to reduce inequality of service. The Committee was advised that the trial had been successful with stroke specialist nurses giving a quick diagnosis and ensuring patients were treated accordingly via the correct pathway, making appropriate referrals within 12 hours.  This had enabled the correct referral for those presenting as 'stroke mimics' and had enabled the most appropriate treatment and rehabilitation programme.

·  It was noted that psychological services was not highlighted in the report. It was felt that the emotional aspect and impact on mental health from stroke needed to be addressed.

Following consideration of the report, it was;

Resolved: That;

(i)  The content of the report be noted.

(ii)  The decisions to be made about the Stroke programme by commissioners and providers in the next few months be noted.

(iii)The programme and work going forward be endorsed.