A major review has been launched into stroke services across the Midlands and the East of England in an attempt to improve survival rates and reduce disability, HSJ has learned.

The review by NHS Midlands and East strategic health authority cluster seeks to eradicate variations in the standards of care and is likely to result in a significant reconfiguration of services.

HSJ has been told the review is expected to see the care for acute emergency stroke patients concentrated into hyper-acute stroke units, with existing local departments closed or downgraded.

A majority of hospitals across the Midlands and East see less than 500 stroke patients a year.

However, a service specification for what the stroke pathway will look like once the review is complete is expected to call for a minimum of 600 patients annually.

The review will also focus on improving the whole care pathway, including rehabilitation and discharge back home.

Clinical networks across the region are leading work on drawing up new requirements but the SHA cluster has also established a panel of stroke experts to assess the plans and make final recommendations.

Tony Rudd, stroke review chair and lead for stroke at the Royal College of Physicians, said that despite improvements there were still inequalities in the standards of care people receive depending on where and when they have a stroke.

He said: “The reorganisation of stroke care in London has been a major success but I know full well that the solutions we used in London are not going to be directly transferrable to the Midlands and East of England.

“We have to ensure we find systems that are appropriate to the regions and build on existing high quality services.”

Sally Standley, who has been seconded to the SHA from Cambridge University Health Partners to lead the project, described the work as a “major priority across the region”.

“Wherever possible we will build on existing good practice in the region, rather than starting with a blank sheet of paper, and will work with and through local organisations to ensure they have the opportunity to shape the future,” she added.

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