Aims and objectives

The Stroke Health Integration Team (HIT) will focus on five key areas, to improve stroke prevention and care in our region.

It’s better to prevent a stroke than to treat one

Recent improvements in stroke treatment are exciting, but preventing strokes is much better.

Many people still ignore stroke symptoms that go away quickly (Transient Ischaemic Attack or TIA), when they should go straight to their GP or call 111, because four out of every five strokes after TIA could be prevented with early treatment.

The HIT will help improve rapid access to TIA clinics for people across Bristol, North Somerset and South Gloucestershire (BNSSG).

Thousands of people in BNSSG have high blood pressure but don’t know it; others have high blood pressure that should be better controlled. High blood pressure is the main risk factor for stroke.

The HIT is supporting work to improve detection and treatment of high blood pressure.

Many people have atrial fibrillation (an irregular heart beat) but because this was diagnosed some time ago they’re not getting the most modern and effective blood thinning treatments.

The HIT is supporting work to improve detection and treatment of atrial fibrillation.

Improving immediate (“hyperacute”) stroke treatment

After stroke, immediate (“hyperacute”) treatment over the first hours and days is crucial for recovery.

In London, death rates from stroke were reduced by centralising hyperacute stroke care into large hyperacute stroke units (HASUs). NHS England intends to centralise stroke services across the UK.

With support from the HIT, there is the real possibility that we will be the first region in the South West to centralise hyperacute stroke services.

Removing clots causing stroke from arteries in the brain (“thrombectomy”) doesn’t work for everyone but dramatically improves recovery for many people with the most severe strokes. This treatment is carried out for many people across BNSSG but cannot be provided 24-7 because of a shortage of hospital space and doctors.

The HIT will support service improvements to help provide this treatment to more people, and will help inform patients and the public about this important treatment and the difficulties we face in delivering it.

Improving recovery, care and support after stroke

Fewer people would need residential care after stroke in BNSSG if the right services were available following discharge from hospital. In particular there is no early supported discharge service for stroke in North Somerset.

Recovery often continues for many years after stroke. Services need to change to support people for longer after their stroke.

Services provided by hospitals, home-based (“community”) rehabilitation organisations and social care services in local authorities need to work together better.

The HIT is supporting service improvements and research into improving rehabilitation in people’s homes and community hospitals after stroke.

Supporting improvements through research

We can only know the best way to improve health and care through good research.

Research is one of the main purposes of all HITs.

The HIT supports collaborative research which aims to improve stroke prevention, treatment and care, is guided by local stroke survivors and the public, and is relevant to local health and social care services.

Members of the University of Bristol and University of the West of England, the National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), the West of England Academic Health Sciences Network (AHSN) and the West of England Clinical Research Network (CRN) are all involved in the HIT.

Supporting improvements through training and education

Education is another of the main purposes of all HITs.

Improving public awareness of stroke, particularly what causes it, how to reduce your risk and how it is treated, will help people to be more involved in their own health and help prevent stroke.

The HIT will help to develop an online training resource for patients and carers.

Helping to guide training programmes for people involved in stroke prevention and care will ensure that we have people with the right skills in our health and social care services.