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Graphic: Urgent call to address ‘chronic’ staffing shortage at Norfolk stroke centres

11:42 16 July 2014

An East of England Ambulance Service ambulance in Norwich.

An East of England Ambulance Service ambulance in Norwich.

Archant Norfolk

Urgent calls have been made to address a “chronic shortage” of specialist doctors, nurses and therapists to improve the standard of stroke services across Norfolk.

Reaction to the report

Matt Broad, locality director for the ambulance service, said: “We have remodelled our service in Norfolk to prioritise the use of ambulances over rapid response cars. We have also increased our ambulance cover in areas such as Cromer, Diss and Fakenham. As a result we’ve seen our care for stroke patients improve which will continue as our recruitment campaign progresses. Stroke care is one of our seven key clinical priorities in 2014/15 and we are aiming to achieve continuous improvement in getting people who have suffered a time-critical stroke to a specialist centre within 60 minutes.”

Chris Cobb, director of medicine and emergency services at the N&N, said: “We are making good progress to deliver the recommendations. Our consultant recruitment has been completed and we will have three additional consultants in place by October 1. The recruitment of three registrars and one speciality grade doctor is ongoing. We are also in the process of recruiting eight additional stroke nurses.”

A spokesman for the Queen Elizabeth Hospital added: “We intend to recruit a fourth stroke consultant and we will be advertising shortly. We are also in the process of recruiting a matron for stroke services, to strengthen management of our nursing team.”

Great strides have been made to improve treatments for a condition where quick treatment is often the difference between life and death. However, services across Norfolk are not meeting the “gold standard” and patients need faster responses and more long-term support when they come out of hospital, according to a new report.

Health chiefs from the ambulance service, three stroke units in Norfolk, rehabilitation services, and commissioners have been urged to work closer together to improve the standard of care for people who have suffered a stroke.

A report by the Stroke Services in Norfolk Task and Finish Group has also called on NHS bosses to urgently fill a number of senior position vacancies at specialist stroke units and bring staffing up to acceptable levels to help meet targets and improve outcomes for patients.

Councillors, who will report back to the Norfolk Health Overview and Scrutiny Committee tomorrow, said that some parts of Norfolk were “under served” because of differences in the way three rehabilitation services were run and commissioned.

Stroke report info-graphicStroke report info-graphic

Margaret Somerville, chairman of the task group, said clinical networks and commissioners have been looking at stroke services in Norfolk for the past three years without making any significant changes and it was “time for action.” She added that some progress had been made to improve services, but the report make 20 recommendations for NHS chiefs.

“There is certainly great dedication and professionalism in all of our acute and rehabilitative stroke teams. However, it was equally clear to us that the ‘gold standard’ in stroke care is not being achieved across Norfolk. People need to get to hospital quicker, more should get thrombolysis, and there is a great need for longer term support for people living with the after effects of stroke.”

“The real difficulties in recruiting stroke specialist and other staff left our stroke teams running below par for too long. It is an all too familiar story and yet another NHS workforce issue that needs to be urgently addressed,” she said.

The Norfolk and Norwich University Hospital has opened 12 extra stroke beds in the last year. However, despite performance improvements, the hospital is not hitting some key stroke treatment targets and is looking to recruit three specialist registrars and one speciality grade doctor by August 1. It is also looking to hire eight qualified stroke nurses.

Spotting the signs of a stroke

People are urged to act FAST when they spot just one of these symptoms of a stroke:

Facial weakness: Can the person smile? Has their mouth or eye drooped?

Arm weakness: Can the person raise both arms?

Speech problems: Can the person speak clearly and understand what you say?

Time to call 999.

The Queen Elizabeth Hospital in King’s Lynn has a vacancy for one stroke consultant and the James Paget University Hospital currently needs two qualified stroke specialist consultants.

Five key recommendations from the report

• That the East of England Ambulance Service reviews the number and location of ambulance bases in Norfolk in relation to travelling times to the hyper acute stroke units with a view to achieving the Stroke 60 standard in all parts of the county.

• That the stroke team at the Norfolk and Norwich University Hospital should be a stand alone team, as is recommended in the National Stroke Strategy 2007.

• That the James Paget University Hospital urgently increases the number of stroke specialist consultants in its service.

• That the Norfolk and Waveney Stroke Network reviews the number of stroke specialist staff in post and stroke rehabilitative services. The stroke network is also urged to assess the three rehabilitative stroke services in Norfolk with a view to commissioning services in future that bring the maximum benefit to the greatest number of patients.

• That Health Education East of England explains what is being done to resolve the shortage of stroke specialist consultants and other stroke specialist staff.

What are your experiences of stroke services in Norfolk? Email adam.gretton@archant.co.uk

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