Stroke Group update

21 Feb 2014

Intercollegiate Stroke Working Party (ICSWP) Letter 26.6.14 to BSRM/SRR

Update on the Intercollegiate Stroke Working Party where Prof Derick Wade represents the SRR. For members who may wish to have an update and respond about the Future Hospitals Commission. Please see letter sent via email to members 24.7.14 click HERE


Intercollegiate Stroke Working Party (ICSWP) Letter Feb 2014 to BSRM/SRR

Dear SRR Members

Prof Derick Wade and the IC working party have posed some specific questions for SRR members, which I would like to bring to your attention regarding guidelines and future hospital commissions:

The Questions posed by Derick, which relate to the National Stroke Clinical Guideline development are;

Scope, and questions

In my view one of the great features of the guideline is its broad scope, but this is difficult to maintain and it is quite possible that we have overlooked important matters.  We will be discussing the scope on June 16th2014.

Could you and members of each society consider:

  • Are there any areas or questions not covered by the guideline that should be?
  • Is the scope reasonable?  Should it be expanded?  If it is reduced, any suggestions about what must be kept and what could be reduced?  Are the recommendations too detailed and specific or too vague and non-specific?


At present it has:

  • Hard copy (only a few copies sold)
  • Free copy for download
  • An app in IOS and Android
  • Patient version
  • Profession specific summaries

 This is quite expensive and adds 8-12 weeks to the process.

 What do members of each society think about:

  • Need for hard copy, book?
  • Need for Apps?
  • Need for profession-specific version?

 There was also some discussion about the content, with some parts having longer and more detailed introductions, or explanations on how a recommendation was arrived at and others shorter text.  Do society members appreciate more or less accompanying text and explanation?

 Any other comments

Any other comments on what is good, what needs improving and so on would be helpful.  For example, is it reasonably balanced in terms of recommendations and amount of attention given o different parts?

 Derick also asks for members comments on….

 Future Hospital Commission

As most doctors and many others will know, the Royal College of PhysiciansCRE-2013-3160 recently published a document on the development of hospital services.  Associated with this was another document the Shape of Training, and this is all in the context of the Stafford Hospital enquiry and other related documents.

 One issue specifically affects stroke, along with many other specialised services.  The general thrust seems to be towards less specialised care:

  • The patient will remain under one consultant from admission; if admitted under an endocrinologist, he or she will remain the lead consultant
  • The patient will remain in one ward; if admitted to a non-stroke ward the patient will remain there
  • All doctors will take on more general work

 This threatens the progress made over the last ten years, whereby most patients are now cared for in a stroke-specialised environment (especially nursing) by stroke-specialised teams (including nurses).

 If members of the two societies have views, they should be given soon.  More importantly, any suggestions on ways to resolve this tension or dilemma would be most welcome.  Comments by BB can be sent to the RCP directly on [email protected], and we would appreciate a copy sent to sean.[email protected].

 In a separate email perhaps Derick also wants information for a Community organisational audit

 Of services that provide:

 Any rehabilitation (specialised or not) to

  • Patients who have had a stroke who
  • Are living in (accommodated in at the time):
    • Their own home or another person’s home
    • A nursing home or care home
    • A community hospital not an integral part of the acute stroke pathway

 The service may actually be provided:

  • In the accommodation
  • In a day hospital or day centre
  • In an outpatient setting

 And the host organisation may be:

  • An acute hospital Trust
  • Any other NHS Trust
  • Any private or not-for-profit organisation

 Then please let us have your service name and contact details to [email protected] 

To view the letter from Derick Wade to teh BSRM and SRR please click HERE

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