Patient Story

Meeting: Public Board

Date: 08.11.2023

Report Title: Patient Story

Agenda Item: 1.4

Author: Lynda Steele, Deputy Clinical Director (Quality and Safety)

Lead Director: Simon Chase, Acting Chief Paramedic/AHP and Executive Director of Quality

Purpose: Discussion/review

Link to strategic risk(s):

SR1: Failure to deliver a timely service to our patients in line with commissioned national standards, to ensure a safe level of service
SR2: If we do not deliver operational and clinical standards then there is a risk of poor patient outcomes and experience
SR5: Ability to embed EEASTs place within the changing system to support delivery of the NHS Long Term Plan

Equality impact assessment: No negative impact identified

Recommendation For the Board to recognise work underway to improve stroke care to patients of east of England in challenging times the NHS and ambulance services are expected to respond within.

Previously considered by This has not been viewed elsewhere.

Purpose To share patient views of the service and the learning the Trust are undertaking to improve patient care around stroke, currently a leading course of death in the UK (Stroke Association).

Executive summary

This story arose from a patient experience concern received by the Trust. Stroke emergencies are coded as a category 2 call (expected response within 18 minutes). The Trust are currently responding to category 2 calls in under 40 minutes and have a trajectory and ambition to deliver a mean of 30 minutes. Every minute over 1.9 million neurons can die due to a stroke left untreated (National Institute of Neurology). The call highlights the importance of good communication with patient and family when attending a 999 call and transporting to a Hyper Acute Stroke Unit as soon as possible.

Introduction/Background

This patient story was produced in collaboration with the Bell family. Jayne woke on the morning initially feeling well and not reporting any unusual symptoms. Later at about 07:00 hours her husband noticed her speech was slurring and she had lost simple co-ordination. He thought she was having a stroke. He dialled 999 just after 09:00 hours requesting attendance of an ambulance. This was coded as C2 Stroke response. The caller was informed that C2 calls were being answered in approximately 40 minutes on that day. The crew arrived on scene 49 minutes after the call. When the crew arrived, they undertook a full assessment that was well recorded. They noted she had facial droop, full slurred speech and left sided weakness. She was taken to the nearest local hospital for assessment. Following the initial assessment Jayne was transferred to another hospital for a thrombectomy.

Key Issues/Risks

Stroke is often seen by the safety and experience teams as a reported incident or complaint when we have been delayed in attending, due to system pressures leading to additional harm to patients. The number of such incidents and complaints has led to Stroke being one of the thematic reviews being undertaken under the PSIRF plan. Delays in attendance to stroke patients may lead to patient deterioration and exacerbate the disability caused by the stroke.

Options

N/A

Summary

The Trust can learn from positive outcomes as well as the negative ones. This case identifies that good communication, good assessment and record keeping support patient experience and potentially their clinical outcome too. The timeliness of response will also inevitably have an impact on patient outcome.