What progress has been made in implementing the recommendations in section 5 of the report, A Progressive Stroke Pathway, which was publish…

The Scottish Government Published the Stroke Improvement Plan in June 2023, which considers the recommendations made in the Progressive Stroke Pathway and sets out the Scottish Government Policy on Stroke. An update on the recommendations made in section 5 of the Progressive Stroke Pathway, produced by the National Advisory Committee for Stroke (NACS), is as follows.
Awareness raising:Priority two of The Stroke Improvement Plan, published June 14, 2023, commits the Scottish Government to establishing the current degree of public understanding of stroke symptoms and the action required, and whether certain at-risk groups require different messaging.The Stroke Improvement Plan also commits the Scottish Government to supporting the delivery of Face, Arms, Speech, Time (FAST) campaigns, ensuring this messaging reaches all at-risk groups.We will work with third sector organisations and health marketing colleagues to consider the most effective way of raising public awareness, including the less common symptoms of stroke
Pre-hospital assessment:The Stroke Improvement Plan commits Scottish Government to supporting Scottish Ambulance Service (SAS) in exploring the feasibility of using video call technology prior to arrival of ambulance resource to diagnose hyperacute strokes more accurately.SAS is progressing the development of a quality improvement initiative for operational ambulance crews to receive clinical feedback regarding diagnostic accuracy and the application of FAST.Work being undertaken to re-align NHS24 and SAS clinical pathways for suspected stroke patients to ensure consistent levels of response in-line with Medical Priority Dispatch System (MPDS) coding.In collaboration with NHS Tayside, SAS is progressing work to evaluate the use of the Los Angeles Motor Scale (LAMS) stroke screening tool.SAS is undertaking a comprehensive review of linked clinical data to understand link between clinical outcomes and priority dispatch coding, to ensure the most appropriate use of resources for patients most likely to benefit from thrombolysis and/or thrombectomy.
Appropriate referral:The appropriate referral of patients experiencing stroke events, including those with acute ongoing symptoms, resolved symptoms and stroke-like events remains the responsibility of clinicians managing their care.Through the National Thrombectomy Planning Board (NTPB) work is being undertaken to ensure there is a robust process for appropriate referrals of patients who may benefit from thrombectomy procedures in one of the three thrombectomy hubs across Scotland.
Driving advice and secondary prevention:Since the publication of the Progressive Stroke Pathway, the criteria by which NHS Boards’ stroke service provision is assessed in Scottish Stroke Improvement Programme reviews has been expanded.NHS Boards should be able to demonstrate that the provision of tailored driving and return to driving advice is embedded in their stroke service.The revised Scottish Stroke Improvement programme review criteria stipulate that NHS Boards should be able to demonstrate that TIA services ensure the provision of driving advice to all patients.The revised Scottish Stroke Improvement programme review criteria also stipulate that NHS Boards should demonstrate pathways in place for the commencement of appropriate secondary prevention in patients presenting with TIA or minor stroke.We will work with third sector organisations and health marketing colleagues to consider the most effective way of raising public awareness, including the less common symptoms of stroke