In respect of the options for providing the right number of acute stroke centres for our area:
The first part of the options process was to consider how many acute stroke centres were needed to ensure a feasible, clinically appropriate, high-quality service could be delivered.
We currently have 5, so we looked at:
5 centre model, 4 centre model, 3 centre model, 2 centre model, Single centre model.
Our stroke numbers ruled out single and 2 centres, as the numbers would overwhelm this number of centres, would need greater levels of workforce and would mean more people travelling for the first 72hrs of care.
3 acute stroke centres was classed as the optimum number for the whole of Lancashire and South Cumbria
Both 4 and 5 centres were ruled out as completely unaffordable in terms of finance and workforce.
Once this was determined, it was then necessary to consider which of the existing stroke centres were best placed to become the future acute stroke centres.
Two of the centres, in East Lancs and Preston, were automatically chosen to be sites on the basis of the number of stroke going to these local hospitals (greater than 600) and Preston being co-located with the regional Thrombectomy centre.
The third centre was decided by using evaluation criteria agreed with stroke patients and carers, health and care professionals and commissioners, to assess each of the stroke centres accordingly. Furness General Hospital (FGH) was ruled out as outside the travel times for a greater amount of people. Due to the distance to travel, all patients who would normally attend FGH would continue to do so, but would be assessed using the triage, treat, transfer model to determine which patients would need to travel onto to an acute stroke centre for the first 72hrs of care.
Through the evaluation process it was determined that Blackpool should be the third centre, scoring above Royal Lancaster Infirmary (RLI). Once this was determined the model originally advocated triage, treat and transfer at RLI but, due to a clinical challenge from National Clinical Stroke Director, this was changed to a direct divert for RLI patients to the nearest Acute Stroke Unit which is Preston.