How we made our decisions
In a major review during 2007, as part of a national review of the NHS, NHS East Midlands asked around 4,500 members of the public and 500 health and social care staff about the healthcare issues that mattered to them. There was strong support for specialised services dealing with heart attacks and strokes.
The details of our proposals were developed with local doctors and the people responsible for commissioning healthcare. A clinical summit was held in September 2008 to review current stroke and heart attack services across the region, and to discuss the development of a new service model. Clinical Advisory Groups were set up as a result of this summit, and met regularly to develop the service model and the minimum standards of care that should be on offer.
We also sought views on the proposed changes from patients, carers and their representatives during a series of small workshops in November and December 2008. During the summer and autumn of 2009 we held a series of engagement events around the region to seek the views of patients and the public on our more detailed proposals.
How we decided which hospitals should offer specialist stroke care
We collected data on past strokes, where and when they tend to happen, and the population in each area, to help us anticipate how many people will need care across the region. We also looked at how long ambulance journeys take in different areas, and we reviewed the strengths and weaknesses of current services.
Our sources included East Midlands Ambulance Service, East Midlands Public Health Observatory, the performance intelligence unit of the Strategic Health Authority (SHA), and the Nottingham Stroke Unit. The accuracy of this data was checked with the health community.
In July 2009, all NHS hospitals in the East Midlands that offer emergency care were invited to apply to provide a specialist PPCI centre and/or a level of care for heart attacks and chest pain that meets new quality guidelines.
A panel of independent experts, including doctors from within and outside of the region, have now assessed these proposals. They visited each hospital to review the care they provide at the moment and discussed with clinicians and managers how they would deliver the new services.
We then put together our final recommendations for creating our new regional system of care for stroke, including where the specialist centres should go. In February 2010, these recommendations were presented to our local primary care trusts (PCTs) who are responsible for commissioning the new services for the people in their area. They agreed to fund the new specialist centres.
The hospitals which have been accredited as specialist centres are now working hard to implement the new services as quickly as possible so patients start to get the benefits.