National Stroke Implementation Network

The Quality Statement for Stroke was published by the Minister for Health and Social Care in September 2021 and replaces the previous Stroke Delivery Plan for Wales. 

The Quality Statement for Stroke has been developed in partnership with the former Stroke Implementation Group and a range of key partners, including the Stroke Association. It focuses on improving services across Wales and reducing variations in care. The statement also describes what we should all expect to see from our stroke services in Wales – with a focus on safe, timely, effective, person-centred, efficient and equitable care. 

To achieve the vision set out in the quality statement for stroke, we need a strong focus on cross-working with other groups to address areas such as public health, prevention, rehabilitation, care for the critically ill and people who are at the end of their lives. It also requires close collaboration with other conditions, such as cardiovascular disease, neurological conditions and diabetes.

In July 2022 the Collaborative Chief Executive Group, made up of Chief Executives from across NHS Wales agreed to establish a National Stroke Programme Board to take forward the development of Comprehensive Regional Stroke Centres and their associated Operational Delivery Networks. This was then further endorsed by the NHS Leadership Board.

In April 2023, the then NHS Wales Health Collaborative moved to sit within a new NHS Wales Executive, as a Networks and Planning function. The NHS Executive will play an important role in making our healthcare system fit for the future and drive improvements in quality and safety, resulting in better and more equitable outcomes, access, and patient experience, reduced variation, and improvements in population health.

More information on the NHS Executive can be found here.

With the establishment of the NHS Executive in April 2023 the National Stroke Programme Board was subsumed under the Cardiovascular Strategic Network as a Stroke Implementation Network, with the work to develop a comprehensive regional stroke model forming a key part of the Network's portfolio of work.

One of the key aims of the Stroke Implementation Network is to look at how we can provide comprehensive, highly specialised services for stroke patients within the first 72 hours of experiencing a stroke.

We know from evidence that timely, highly specialised interventions during those early days in a stroke survivor's journey are the most critical to achieving better outcomes. The programme of work will look at services across the whole pathway, from prevention of stroke, through to living well beyond a stroke and will focus on developing innovative solutions using digital technologies.

The Quality Statement for Stroke indicated the following high-level aims directly relating to the development of the comprehensive regional stroke model for Wales:  

• A continued system-level focus on transforming pathways in line with evidence base and clinical guidance to enable recovery and reset of services to pre-pandemic levels
• Support a new model of provision of stroke services through comprehensive stroke centres and a networked approach to cross boundary working that seeks to improve the whole patient pathway including access to diagnostics, interventions, rehabilitation, including early supported discharge and psychological support services
• Services will be reconfigured to produce the outcomes expected in high quality, patient focused services and to ensure national standards can be met consistently and sustainably
• Ensure that innovations and targeted interventions are available across the stroke pathway to all stroke survivors in Wales
• Rapid access to confirm stroke and provide evidence-based interventions, treatments and care in the most appropriate setting are routinely available. 

We have brought together representatives from across NHS Wales, Welsh Government as well as the Stroke Association and Llais (formerly Community Health Council) to achieve this. This work cannot be achieved without listening to and involving our service users. To ensure we do this robustly we will shortly be appointing a new Patient Engagement and Involvement lead, a post that has been funded by the Stroke Association.

We aim to put service user views and experiences at the heart of our decision making alongside robust clinical evidence and practice elsewhere in the UK and Europe.

We recognise that Wales is geographically diverse, and that rural and urban areas will likely require differing solutions. That is why we are working with health boards across Wales to ensure the views of those populations are heard. 

The work will look at services being provided now and identify ways that they can be improved in the short medium and long term. It will also look at the significant workforce challenges that we and the rest of the UK have experienced for many years and the impact that this has on the outcomes for those who experience a stroke. The views of both those who work within the service and those who use it will be paramount in developing future models of care for Wales.

The Stroke Association has provided several documents which may be helpful in articulating the challenges we have and the opportunities to improve.