Out of Hours Telestroke Service for Lancashire & Cumbria Cardiac and Stroke Network
The Lancashire and Cumbria Telestroke Network is a collaboration between six Acute Trusts (across 8 hospitals) and seven PCTs in Lancashire and Cumbria whose aim was to deliver 24/7 stroke thrombolysis for patients with acute ischaemic stroke living in rural areas. Lancashire and Cumbria began providing a 24/7 Stroke Thrombolysis Telestroke Service in July 2011. It is an equitable, evidence-based service which provides a remote, timely, efficient, quality assessment of the patient by a remote Stroke Physician Consultant at any time of the day or night. The service has demonstrated considerable cost-savings on long-term care for the stroke patient, and has a positive impact on the workforce due to improved service delivery. It releases time for Doctors and Nurses in busy A&E Departments and it takes pressure off radiology clinical leads and imaging managers.
There is a network of 16 stroke physicians across eight hospitals. Some Acute Trusts provide three consultants per rota, others two. An on-call Physician rota ensures cover across the whole network alleviating the pressure for individual Trusts to provide cover 24/7. The Telestroke solution is based on Polycom’s HDX high definition videoconferencing technology with mobile carts in A&E and Polycom’s CMAD desktop client videoconferencing software installed on the clinician’s home PC. The solution enables a remote specialist stroke physician to see and speak to the patient and the local clinical team, and also review the CT head scan images, all in high definition. The physician is able to confirm the diagnosis of stroke, assess the severity, exclude haemorrhage on the CT head scan and advise the local A&E team with the patient, whether thrombolysis treatment would be of benefit. Each consultation is recorded for training and governance purposes.
In the first 18 months of use, since the launch in July 2011, 523 patients have already benefited from a remote video consultation via Telestroke, and 200 patients have received thrombolysis. The potential cost saving in Lancashire and Cumbria is £1.8million annually, which equates to £18 million over ten years. In addition, the DH National Stroke Strategy Impact Assessment identifies the average ten year cost of dependent stroke as £56,381 per person. The modelling suggests that after the introduction of 24/7 thrombolysis there will be 60 less high dependency patients per year. The additional potential cost saving in Lancashire & Cumbria is therefore £2.03 million over ten years. The modelling suggests that every year there will be 24 patients alive who would have died, 36 less patients who are dependent, and 40 more patients with no symptoms or significant disability.
The Telestroke service has reduced the need to contact on-call radiologists, thus reducing their workload, A&E Departments are benefitting as both doctors and nurses are now using the Telestroke service speeding up treatment for stroke patients and saves time waiting for consultants to arrive. Dr. Mark O’Donnell, Stroke Consultant at Blackpool Teaching Hospitals NHS Foundation Trust and Clinical Lead for the Lancashire & Cumbria Cardiac and Stroke network said, “We are using this new technology to take the stroke specialists to the patient, rather than moving the patient long distances around rural areas to where the specialists work. In an acute stroke, time is of the essence and the sooner treatments can be provided the better.”
MultiSense Communications Ltd, Polycom’s leading Telemedicine solutions provider in the UK and Ireland, designed, implemented and supports the entire solution in partnership with the Lancashire and Cumbria Stroke Network. Our specialisation is the development of telemedicine solutions for the NHS and includes solutions for; burns, cancer, ophthalmology, dermatology and more. For more information contact us.