Friday 03 May 2024
Internal Reference Number: FOI_7425
Date Request Received: 13/09/2023 00:00:00
Date Request Replied To: 26/09/2023 00:00:00
This response was sent via: By Email
Request Summary: Stroke Unit
Request Category: Private Individuals
| Question Number 1: Does the trust have, or is the trust looking to obtain a HASU (Hyper Acute Stroke Unit) status? | |
| Answer To Question 1: Salisbury NHS Foundation Trust has a HASU admitting patients directly 24/7 and offering comprehensive hyper-acute treatments. Thrombolysis is available 24/7 with immediate access to advice from stroke specialist 24/7. Patients are also assessed for Mechanical Thrombectomy. The nearest tertiary centre for mechanical thrombectomy is Southampton General Hospital whose services are currently available 08:00 to 20:00, seven days a week. Royal College of Physicians states that a HASU should include; • Specialist medical staff trained in the management of stroke patients, including the diagnostic and administrative procedures needed for the safe and timely delivery of stroke treatments. Yes, this is available. • Specialist nursing staff trained in the management of stroke patients, covering neurological, general medical and rehabilitation aspects. Yes, this is available. • Rehabilitation specialists trained in stroke. Yes, this is available. • Diagnostic, imaging and cardiology equipment such as brain scanners. Yes, this is available. • Tertiary services for endovascular therapy, neurosurgery and vascular surgery. Yes, this is available. • Continuous access to a consultant with expertise in stroke, with a consultant reviewing patients every day. We do have access to stroke consultant continuously. We currently have stroke Consultant reviewing patients twice daily five days a week and Medical Consultant two days a week. | |
| Question Number 2: If yes, what is the trust’s HASU status? | |
| Answer To Question 2: Based upon the criteria above, Salisbury NHS Foundation Trust fulfils the criteria to be classified as being a HASU provider. We admit less than 600 patients with a stroke diagnosis annually but we do serve a rural community where the majority of travel times would be more than an hour if regional reconfiguration was considered. | |
| Question Number 3: If not, what is the trust’s timeline to gain the HASU status? | |
| Answer To Question 3: Not Applicable | |
| Question Number 4: How does the trust manage stroke litigation? | |
| Answer To Question 4: Any litigation involving allegations related to stroke is managed no differently from any other litigation. It will follow the pre-action protocol for clinical negligence (in the public domain) and then will be court managed if the matter is issued in court . There is no separate ‘stroke’ management protocol. | |
| Question Number 5: What were the trust’s costs for managing stroke litigation in the financial year 2022/2023? | |
| Answer To Question 5: The questions is rather ambiguous, therefore please see response breakdown below: Costs incurred by the trust in defending any such claim - NIL as we are not time recording. Defendant costs - NIL as any such claim would be covered by insurance and dealt with by the NHSR under our CNST scheme of insurance. Claimant solicitor costs - NIL as the Trust have not made any payments in relation to any stroke case 2022/23 | |
| Question Number 6: How does the trust currently feed into the SSNAP (Sentinel Stroke National Audit Programme)? | |
| Answer To Question 6: We have two data managers working specifically with stroke and collecting prospective data for all consecutive stroke admissions to the Trust. The data is used for feedback to the stroke team to improve performance, to the Trust to support the development and sustainability of stroke pathways and nationally to report on the Trust’s performance in maintaining stroke standards. | |
| Question Number 7: What steps is the trust taking to improve its SSNAP score? | |
| Answer To Question 7: The Trust is supporting the further development of the stroke service in response to the SSNAP results. The Trust Management team is engaging with the leads for stroke, Emergency Department, Radiology and Site Management to improve the responses to hyper-acute stroke admissions through the Emergency Department. This has seen improvements in many of the acute measures with consistently more than 50% patients having brain imaging within the first hour of arrival, up to 20% of patients receiving thrombolysis (100% of those eligible) and more than 60 % transferring directly to the stroke unit within the first four hours. We have an active stroke operational working group currently developing strategies to make further improvements. This is likely to include a team of Advanced Clinical Practitioners to support patients, their relatives and the teams involved with their care, from the moment they are identified to the point of discharge. The therapy leads are developing working practices to support increasing an individual’s therapy time up to six hours a day and expanding therapy availability from six days a week to 7/7. | |
| Question Number 8: Does the trust have a ‘sophistication index’? E.g. A sophistication index shows the trust’s ability to approve and implement projects | |
| Answer To Question 8: We have a Trust prioritisation process as part of Improving Together – the project delivery system will review potential projects and how they align to Trust strategy and through this process a group called CPPG (corporate projects prioritisation group) will review and approve or not approve. Not every project comes through it e.g. smaller projects which are more continuous improvement in nature or QI projects can still be approved locally or via divisions but anything big, strategic etc. should come via this project filtering process | |
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Our staff at Salisbury District Hospital have long been well regarded for the quality of care and treatment they provide for our patients and for their innovation, commitment and professionalism. This has been recognised in a wide range of achievements and it is reflected in our award of NHS Foundation Trust status. This is afforded to hospitals that provide the highest standards of care.
