Neath Port Talbot and Bridgend Local Health Boards Stroke Services Action Plan

Transcription

1 as outlined in the Sentinel Audit Co-location of beds May-08 designated stroke beds co-located Neutral Agreement and possible public consultation (NPT) on configuration of acute services Sep-08 Staff Time Development of imaging services in line with requirements of Sentinel Audit Mar-09 All patients should have CT within 24 hours Extra CT scanning session on Sundays and additional carotid doppler sessions during the week Availability of monitored beds Mar-09 AOF Monitoring equipment, adequate nursing staff Business case to LHB, as stated in WHC (07) 058 Development of with MDT satffing as set out in RCP guidelines 15,600 Immediate Trust Staff Mar-09 Level 1 Stroke Service in place in line with BASP Various models proposed with varying cost implications Between 800K and 1.970K Identification of number of acute and beds required based on SPP and further analysis of implications of improved TIA and therapy levels on ALOS Identify skills and competencies of staff required for Designated Stroke Unit Identification of currently available appropriately skilled staff Mar-09 80% of stroke pts to >50% of time in Immediate None Immediate None Page 1 of 6

2 as outlined in the Sentinel Audit Identification, employent and training of additional dedicated staff required, dependant on number of beds required. In the first instance this will be an Early Intervention Multidisciplnary Team, based on the stroke wards, with the scope to work across the acute and wards as well as in the community Mar-09 90% compliance with sentinal audit process measures and standards for therapy assessment Additional funding for nursing, therapies, medical staff, Anc Between 800K and 1.970K, but for 2008/09 funding this is 128,750 Development of Identification and provision of therapy space and equipment Mar-09 30,000 Pilot of e-referral system for TIA Sep-08 % of TIAs seen in clinic within 7 days of referral Roll out of e-referral pathway for TIA subject to evaluation of pilot Formalise arrangements for TIA clinics in Ambulatory Care Referral of all TIAs to one stop shop within 24hrs of experiencing symptoms Devise method to assess impact of on primary and secondary care Mar-09 % of TIAs seen in clinic within 7 days of referral Jun-09 No of patients seen in TIA Clinic Dec-09 % of TIAs referred to one stop shop within 24hrs of onset of symptoms June 08 then yearly reevaluation Monitoring of difference in no. of TIAs presenting to trust and no. admitted Trust staff Additional Funding for 0.5 WTE Consultant, Band 3 Nursing and clerical support Staff Time 112K Page 2 of 6

3 Consider role or RCU in commissioning thrombylysis service Sep-08 Guidance form SPP Scoping of provision of thrombolysis service in line with developed by Stroke Partnership Project Mar-09 Implement local policy for thrombolysis service in line with national protocols and QR Mar-10 Public health campaigns Public health campaigns Liaise with NPHS and include their action plans for exercise promotion and smoking cessation Ongoing- refer Improved to CCM Action Lifestyles (WHS) Plan Support from NPHS Effective primary care for of stroke Support programme for GPs through PLT and practice visits on acute management of stroke Development of Local Clinical Interest groups Use of PRISM to identify people at high risk of stroke Apr-08 Evaluation of support programme Nov-08 Quarterly meetings Mar-09 Primary prevention programme Minimal Payment of Consultant and GP sessions Monitoring of QOF Data Ongoing QOF None None Page 3 of 6

4 Specialist short and long term multi-disciplinary ilitation Evaluate possible impact of an Early Supported Discharge Service on the local population and local services Evaluate possible impact of a community based specialist ilitation services on the local population and local services Mapping of current community services used by people with stroke Apr-08 No of bed days saved based on evidence, cost analysis Apr-08 No of bed days saved based on evidence, cost analysis Apr-08 Agreed service map Staff time, Trust and LHB Staff time None Identify a clear pathway for people who have had a stroke to access ilitation in the longer term. Agreement of high level pathway, with identified gaps in service and local priorities Apr-08 variance tracking against an extended ICP Jul-08 Agreed pathway and priorities Staff time Minimal Implement national protocol and QR for timing and range of ilitation assessments and interventions that should be available on acute Develop model for generic integrated community based ilitaion for cardiac, pulmonary and stroke patients, to provide link between specialist iltation and self care. Mar-09 Audit against RCP standards Apr-09 No of stroke patients attending community based programmes Dependant on SPP Establish staffing levels, competence and ilitation facilities for stroke beds in line with national protocol and QR developed by SPP Mar-10 Audit against RCP standards Dependant on SPP Page 4 of 6

5 Specialist short and long term multi-disciplinary ilitation Implement national protocol and QR for timing and range of ilitation assessments and interventions that should be available on transfer form acute to stroke beds where early discharge home not appropriateacute Mar-10 Audit against RCP standards Dependant on SPP Commission appropriate community services ( ESD/ stroke out-reach team/ community based specialist servoces/ day hospital/ outpatient therapy) based on the gap analysis Mar-10 Services in placesentinel audit 237K Effective links to social services, family/carer support, education and self help/return to work etc. Monitor services provided by Stroke Association and Carers Association and ensure that meet QR set out in SPP national protocol Evaluate links with social services and responsiveness to requests for adaptations and care packages Increase the number of referrals of people with stroke to Expert Patient Programmes to promote self help Strengthen links with Pathways to Work programme and CRDT to support return to work Including: Family and carer support Information for secondary prevention Advice for support within the community Mar-10 Staff Time Immediate Staff Time Ongoing, 20% increase from Staff Time establish baseline 2006/07 baseline Ongoing, 20% increase form Staff Time establish baseline 2006/07 baseline SLA 58,108 for Bridgend Page 5 of 6

6 Palliative care Palliative care Assess appropriateness of end of life pathway for people who have had a severe stroke Immediate Audit against Staff time and SPP national guidelines Guidance Palliative care Assess capacity of palliative care services Immediate No of referrals taken Unmet need Continuing Care Staff time Continuing Care Monitor number of CHC referrals for stroke Ongoing Staff time and increase in cost Sustainable and Responsive Service Development Sustainable and Responsive Service Development Establishment of Local Clinical Interest Groups Nov-08 Minimal Sustainable and Responsive Service Development Development of clinical leadership skills in primary and secondary care Ongoing see Clinical Engagement Framework and CCM Action Plans Minimal Page 6 of 6