To consider a report from Lancashire and South Cumbria Health and Care Partnership (copy enclosed).
The Committee considered a report by Lancashire and South Cumbria Health (L&SC) and Care Partnership regarding the Enhanced Network Model of Acute Stroke Care and Rehabilitation in Lancashire and South Cumbria.
Members were informed that the reduction of mortality and dependency due to disability after stroke remained a key strategic priority for the L&SC health and care economy in 2021. Officers explained that the shared vision of all stakeholders in the system, inclusive of stroke survivors, was to deliver sustainable and equitable acute stroke care to benefit close to 6,000 people across Lancashire and South Cumbria who attended the hospital emergency department with suspected stroke symptoms each year.
The Committee was informed that the Business Case sought to address the unwarranted variation and increase thrombolysis and thrombectomy rates to the national ambition. It was explained that as a system there was a need to increase the speed and capacity with which the acute stroke and ambulance services could respond to stroke to save lives and reduce disability. Members noted there was an expectation to improve patient outcomes in the region of 36 more lives saved and 360 stroke survivors with less disability each year.
Officers explained that commissioner investment over a three-year period had been approved to implement an Enhanced Network Model of Care. Members noted this was designed to optimise workforce capacity, stroke beds and ensure nationally recommended travel times to hospital emergency departments across the county’s semi-rural geography were not compromised.
Representatives of the L&SC Integrated Stroke and Neurorehabilitation Delivery Network were in attendance and provided:-
· an explanation of the anticipated clinical benefits for the residents of South Cumbria;
· an update on the proposed operational delivery model and the identified impacts on the residents of South Cumbria and existing acute stroke services in the Morecambe Bay area;
The Chair of the Patient and Carer Assurance Group informed members that the Group supported the proposal, highlighting how this could reduce future mortality rates and disabilities. The Committee was informed that more recent engagement visits to Stroke Association support groups in July 2021 had again provided support for the proposed model of care. It was explained that the main concerns expressed were around the availability of car parking at Royal Preston Hospital but that further work would be carried out to minimise the impact of increased travel.
Members welcomed the proposals to improve the services and asked what differences there were between the Enhanced Network Model and the Hyper Acute Service Unit (HASU) in North Cumbria. Officers explained that this was a very similar model to the HASU.
A discussion then took place regarding the data provided for the Furness General Hospital and members asked why they were lower than other areas. Officers explained that patients ordinarily attending Furness General Hospital with suspected stroke symptoms would continue to be taken directly there for initial triage and treatment before being transferred to Royal Preston’s Comprehensive Stroke Centre for up to the first 72 hours of multi-disciplinary stroke specialist inpatient care, then repatriated back to Furness General Hospital’s Stroke Recovery Unit for ongoing care and inpatient rehabilitation or discharged home with care from the Integrated Community Stroke Team.
A discussion took place regarding travel times to Preston and members asked whether the HASU in Carlisle had been considered as a quicker option for more northern areas. Officers emphasised the importance of a quick assessment in order to achieve a positive outcome and highlighted the potential need for patients diverted to the HASU in Carlisle to be transferred to Newcastle, therefore, increasing the travel time.
Members highlighted the additional challenges due to the geography of the county and drew attention to the conflict of local care and best care. Officers acknowledged the geographical issues and explained care would be central where necessary but local where possible.
The Committee were informed of workforce recruitment difficulties often encountered but welcomed the willingness for all the trusts across the whole of South Cumbria and Morecambe Bay area to work together to ensure there was resilience to deliver a good service. Officers explained work was being undertaken and advice sought for the recruitment and training of staff to take place over the next 2.5 years with the Plan being progressed by a dedicated Workforce Working Group.
Members raised their concerns regarding staffing levels and asked for reassurances that there would be sufficient workforce in place to provide a resilient service. Officers explained that work was being undertaken with local universities with a view to them delivering training for staff as well as two members of staff from each site attending appropriate courses with the funding being met from the recruitment budget.
A discussion took place regarding the availability of finances and officers explained the capital and revenue had been committed for the next three years with the money ring?fenced to improve services.
Members emphasised the need for a robust and comprehensive communications and engagement plan. Officers explained this would include a multi?factorial approach to ensure the wider Lancashire and South Cumbria public and services were aware of the transformation.
(1) the update be noted;
(2) a further report be made available to the Committee in six months’ time giving an update on the progress made in planning the Enhanced Network Model of Acute Stroke Care and Rehabilitation in Lancashire and South Cumbria.