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Supporting the development of high quality and equitable stroke services, to achieve the best outcomes and experience for patients
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Welcome to our March 2016 bulletin which features the work of the Greater Manchester Stroke Operational Delivery Network (GMSODN), whilst sharing news from the wider world of stroke. 

We now have a mailing list of >370 people, but please share our bulletin with colleagues and ask them to subscribe. We also welcome contributions for future newsletters, so please get in touch. 

Don't forget you can access more information on our website or follow us on Twitter @GMStrokeODN

Stroke pathway news

Updated Stroke Pathway Document Pack
We have released a revised pack (V1.6) with three additions/changes that can be downloaded from our website by registered users (in the stroke pathway section):
  • PRE1 – GM Stroke Pre-hospital pathway flow chart (Updated)
  • GEN7 – Incident Reporting Guidance (New)
  • POST6 – Postcode Repatriation List (Updated) 

PRE1 – GM Stroke Pre-hospital Pathway Flow Chart
The wording within the NWAS exclusions to the pathway has changed to include all patients who have had a seizure within or causing the 999 call. This should mean all seizure patients are now seen at their local A&E department. If patients are still conveyed whilst actively fitting or having had a seizure within this event then please report this to NWAS via the reporting flowchart (PRE2 document).
 
GEN7 – Incident Reporting Guidance
Following discussion at the Clinical Effectiveness Group, we have developed some guidance on what kind of incidents should be reported to the ODN, the process for going about it and how we will deal with the information.
 
POST6 - Postcode Repatriation List
Cross border postcodes have been updated to incorporate the differing options of the nearest hospital for that postcode as some are served by more than one hospital.
 
Rehabilitation documents
Our website hosts a number of documents in the rehabilitation area of our Resources webpage that are available to download for registered users.

Use of Intermittent Pneumatic Compression
Guidance in the use of IPC sleeves across Greater Manchester was agreed at January's Clinical Effectiveness Group in an effort to ensure more consistent use of evidence based devices across the region. Further work to collate and provide guidance on DVT management for stroke patients is underway and will be released shortly.

Patient flow audit
All stroke units took part in a second monthly audit of patients assessed by stroke teams to help understand how patients are flowing through the centralised model. The results will be discussed at the next Clinical Effectiveness Group and are available to registered users on our website (in stroke pathway section).

Outcome measures task & finish group
A group has been established to discuss and advise on suitable measures for the whole stroke pathway. The group will meet in April before involving more widely through further consultation.

Pathway leaflet
We have developed a patient facing leaflet explaining the stroke pathway that you may wish to use locally. 

 

Brain awareness week 14-20th March

This year, the Brain And Spinal Injury Centre (BASIC) is celebrating its 30-year anniversary. During 2016 there will be a number of events taking place, the first of which is their open day on 16th March.

The charity are opening their doors between 10-4pm to demonstrate their virtual reality facility which includes the innovative CAREN machine which can help with cognitive rehabilitation and managing long term neurological conditions such as stroke.
 
No booking is required so visit 554 Eccles New Road, Salford M5 5AP or call 0161 707 6441 for more details.

Training and education in stroke

Training and Education Subgroup
The subgroup has now met three times, chaired by Steph Wolff (MRI) and Paula Beech (SRFT). The group has decided to take forward four pieces of work via task & finish groups:
  1. Competency Frameworks – for foundation level
  2. Foundation level education programme
  3. Senior/Experienced level education programme
  4. Training for staff outside stroke (A&E, GPs, NWAS, 111 etc) – required piece of work now due to pathway issues identified by ODN
Involvement in the task & finish groups is not limited to members of the subgroup, so please respond to this survey to express an interest in getting involved (deadline 14th March).

Stroke study day
Stepping Hill Hospital's stroke team are hosting a training event on 20th May. The day will include speakers on imaging, managing mimics, neuro rehabilitation and anti coagulation. You can find out more and book a place here.

Stroke Association training
The Stroke Association have been working with a Stroke Unit in Solihull, to help their ward staff become fully qualified in Stroke at Level 2 or Level 3. They have developed a video that explains how this has had a positive impact on their ward.     
 
The charity recognises that funding for training can be an issue so they offer to match the number of places you can fund for free (excluding qualification fees). Their courses are nationally recognised and quality-assured and they provide distance learning for their level 2 course, and a blended learning approach of their Level 3 course

Please let us know if you want us to advertise you event as we can feature in our bulletins and add to our website.

Rehabilitation news

Rehabilitation Subgroup
The subgroup has also met three times, chaired by Tracy Walker (North Manchester community) and Lorraine Azam (Royal Bolton Hospital). The group will be focusing on three work streams via task finish groups:
  1. Better and more consistent information provided to patients on discharge including JHSC plans
  2. Improving interaction with social care to reduce delays and access packages of care
  3. Better support for return to work and vocational rehabilitation
There will also be scoping carried out across a range of issues that will then determine further work. Registered users of our website can view the group's work plan in the resources section under rehabilitation.

Again, involvement is not limited to members of the subgroup, so please respond to this survey to express an interest in getting involved (deadline 22nd March).

Commissioning of community rehabilitation services
The network is collaborating with the Neuro Rehabilitation Operational Delivery Network to work with local commissioners on reviewing and improving community rehabilitation services in the region. Currently, services in the different boroughs are very differently commissioned leading to significant inequality for patients following discharge from hospital. 

We hope to move towards more standardised commissioning using an integrated model that will help improve patient experience and outcomes, as well as ensuring more efficient and cost effective delivery of services. We will keep you posted on progress.

SSNAP events

Following a successful event last year, Chris Ashton from the network will be facilitating another user's group to continue to improve understanding of SSNAP audit tool. The meeting is aimed at acute teams and will be held on 11th April at Salford Royal Hospital; you can find out more here. Our service improvement collaborative event has now been rescheduled for 12th May.

We have published a guide of SSNAP top tips and please get in touch with Chris Ashton if you want to discuss any issues with SSNAP data or to find out more about our events.

Involving patients and carers in shaping stroke care

We are delighted to announce the appointment of Gill Pearl from Speakeasy to help us develop and deliver patient and carer involvement in the work we do.
Gill will be leading on this area on behalf of the network, and in the coming months will be focusing on:
  • Appointing a lay Co-Chair to our Board and supporting their induction and ongoing training needs
  • Establishing a Patient and Carer Group to support the work of the network through involvement with our groups and stakeholders
  • Facilitating listening events so we can understand what matters to stroke survivors and their families
Gill will be working with our voluntary sector partners to publicise opportunities to get involved and we will keep you updated with the progress of the strategy.
 

Take a moment

Through March and April 2016, the Stroke Association are raising awareness of the link between high blood pressure and stroke, and we’re showing people just how easy it is to get their blood pressure checked.

On 1st March, the charity will be launching their Take a Moment campaign. They’ll be asking people to take a moment to order a free blood pressure information pack. By downloading the pack they will be taking the first step in preventing stroke, so that they can have more moments doing the things they love, with the people they love.

The free information pack is available to download from their website. The pack provides information about the link between high blood pressure and stroke, details about where to get a blood pressure check and tips on how to maintain good blood pressure control.

You can help the campaign by promoting Take a Moment on your website and through your social media channels. Look out for their Facebook posts and Tweets throughout March and April and share with your organisation’s followers. They’re using the hashtag #TakeaMoment and the Twitter handle @TheStrokeAssoc to promote the campaign.

Stem cells in stroke recovery research

There has been a lot of interest over many years in the potential benefit of stem cells in recovery after brain or spinal cord damage. Neural stem cells  (cells with the ability to turn into any of the types of specialised cells that make up brain tissue) are currently being investigated to see whether, if injected into the brains of people with stroke, they improve function. Many people following a stroke, even if they regain mobility, are left with an arm that simply does not work, or is very weak. There is no proven treatment to improve arm strength, although physiotherapy and occupational therapy are of course vital to help capitalise on any recovery and prevent complications such as tightness of the muscles.

A new study is trying to find out whether injection of stem cells directly into the brain of people with severe arm weakness between 2 and 12 months following stroke is associated with improvement in arm function. This study, PISCES II, is based on an initial study in Glasgow some years ago which showed in a small number of volunteers that the procedure was safe, and in some people associated with improvement. The stem cells being used come from an “immortal cell line” which allows the production of an infinite number of exact copies, with the same stability and properties of the original cell.

A team of researchers and neurosurgeons at Salford Royal Foundation Trust are recruiting potential participants into this study, which involves a great deal of team work with the participant, the stroke research team, the neurosurgical team including theatre staff, neuroradiologists and the research pharmacy, as well as the R&D department. Salford is one of a number of hospitals across the UK participating in this study, which, if successful, will lead to a much larger study to see if this is a treatment that could eventually become a treatment option for people with stroke. More information is available here.

Forthcoming events

All events are now available on our website here. Please let us know if you want us to advertise your stroke related events.

Please get in touch


You can contact the ODN team:
 

Sarah Rickard - Manager
 

 

Chris Ashto
n - Co-ordinator


 

Jane Molloy
- Clinical Lead
 



Jordi Morell - Clinical Lead


 


Lisa Chadwick - Administrator 0161 206 2109




If you have anything you would like featured in our bulletin then please let us know.
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