Manchester stroke centralisation could 'save 50 lives a year'

It is only the second time centralisation of stroke services has been attempted at this scale, following a similar project in London in 2010.

From 30 March all new onset suspected stroke cases in Greater Manchester will be treated at one of three specialist “hyperacute centres” at Salford Royal Foundation Trust, Pennine Acute Hospitals Trust or Stockport FT.

Since 2010 only people in the region calling 999 within four hours of a stroke have been taken to the hyperacute centres.

This has meant that only about 30 per cent of strokes are treated at the centres, where patients can get access to emergency “clot busting” thrombolysis and immediate brain scans.

Under the new plans the four hour time limit will be lifted, meaning for the first time everyone presenting with new stroke symptoms will go to the centres irrespective of where and when their stroke happens.

To make this happen £2m is being invested in services, including on extending the operating hours at Pennine Acute and Stockport’s centres from their 7am-7pm weekday hours, to 7am-11pm, including weekends. 

The centre at Salford Royal will continue to operate on a 24/7 basis.

District stroke units at local hospitals will remain open but their focus will be shifted to patient rehabilitation and recovery.

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The benefit of hypeacute care is in the first few hours after a stroke occurs, so patients presenting at a district stroke centre some time after their symptoms may be treated at their local hospitals rather than the specialist centres.

Alan Campbell, chief accountable officer at Salford Clinical Commissioning Group, which is leading the centralisation, said the change would mean everyone in Greater Manchester would have access to “the best practice care processes which are crucial in the first days after a stroke”.

According to research by University College London, centralisation of the capital’s stroke services has resulted in nearly 100 fewer deaths each year. The same study estimated replicating this in Greater Manchester could save 50 lives a year.

Khalil Kawafi, a consultant stroke physician at Pennine Acute, said the changes would “give people a greater chance of survival and will aid people’s recovery from stroke”.

Kevin Render, a patient representative on the implementation board that has planned the changes, said the move would deliver “true equity in the provision of emergency stroke treatment”.

He added: “In some cases it will mean patients will have to travel further by ambulance to get to the hyperacute unit, but the patients we have spoken to say they are prepared to do this if it means they get the best possible care.”