Stroke
February 2009
Improving care for stroke patients in
London
Introduction
A new stroke strategy, produced by
Healthcare for London, has set out
proposals to redesign hospital stroke
services to ensure that all London
residents who suffer a stroke have
access to consistent, high quality care.
During 2008, bids were invited from London
trusts to demonstrate how they would
provide three levels of stroke services in
partnership with other providers.
If the plans are approved then, from late
2009, St George’s Healthcare NHS Trust
will play a key part in bringing about radical
improvements to London’s stroke services.
These changes will meet new standards
which aim to improve patient survival rates,
increase the speed of recovery and reduce
levels of disability.
Background
In 2007, Healthcare for London: A
Framework for Action set out ambitious
plans for improving the quality of health
services across the capital. The report
identified that outcomes for stroke patients
would improve if they received specialised
treatment in dedicated units.
What is a stroke?
Stroke is caused when the blood and
oxygen supply is cut to the brain,
causing cells to die, resulting in brain
damage. Nearly 11,000 Londoners
suffer a stroke each year and of those
around 2,000 will die as a result.
In June 2008 a Joint Committee of Primary
Care Trusts (JCPCT) agreed to develop
specialist stroke services in London.
At present, there is significant variation in
services across London and only around
half of stroke patients are treated on a
dedicated ward. Stroke is London’s second
highest cause of death and the most
common cause of adult disability.
However, outer London residents, who
have the most limited access to specialist
services, are the ones most likely to suffer
a stroke because the population is older.
By changing the way services are
delivered, many more patients will survive,
they will also be less likely to suffer a
disability and more likely to regain full
independence.
continues…/
 What changes will be made? treated more quickly following the

New service specifications and introduction of a 24-hour assessment

performance standards have been service.

identified, along with three key services to

When will the new services be
provide acute care:
up and running?

• Hyper-acute stroke units (HASU) to The number and location of specialist and

provide the immediate response local stroke units is subject to a London-

• Stroke units (SU) to provide multi- wide public consultation, which started in

therapy rehabilitation and ongoing January 2009.

medical supervision
Assuming the outcome of the consultation
• Transient ischaemic attack (TIA)
agrees with the proposals, it is expected
assessment services to provide rapid
that the new stroke services will start to
diagnostic assessment and fast access
take shape over an 18-month period from
to a specialist
autumn 2009.

It is expected that local hospitals will work For more information about the public
together in networks to deliver the most consultation, visit:
appropriate care for individual patients. www.healthcareforlondon.nhs.uk

What are the benefits?

About St George’s
All Londoners who suffer a stroke will,
St George's Healthcare NHS Trust is one
within 30 minutes, have access to
of the country's largest teaching hospitals
emergency diagnosis and treatment which
treating more than 500,000 patients every
will reduce deaths and disability caused by
year in south west London. The Trust has
stroke. Patients will be taken directly to a
an established national reputation as a
HASU where they will receive expert care,
leading hospital for specialist care
including access to a CT scan and
including neurology, cardiac care, stroke
thrombolysis (clot-busting drugs) if
and cancer.
appropriate.
St George’s also provides excellent care in
When they are stabilised, which is usually
areas such as accident and emergency,
around 72 hours, patients will be moved to
maternity services and care for older
a SU in the same hospital, or at a local
people and children. The Trust’s vision is
hospital closer to home for high quality
to be the hospital of choice for all its
rehabilitation.
patients, whether they are local people or
In addition, patients suspected of having a those from further away who use its
TIA, or ‘mini stroke’, will be diagnosed and specialist services.

Published by the Communications Unit at St George’s Healthcare NHS Trust.

Tel: 020 8725 5151 Email: communications@stgeorges.nhs.uk Website: www.stgeorges.nhs.uk