Consultants put on internet call in bid to improve stroke service

Hospital trusts in Sheffield, Doncaster, Rotherham, Barnsley and Chesterfield have joined forces for the pilot, which will see one stroke consultant on out-of-hours call to cover the whole region.

The so-called telemedicine project will allow stroke nurses to offer thombolysis treatment at any time in any of the five hospitals - an option which has not been open to medical staff until now.

Previously, patients would have had to be transferred from hospitals which did not have a consultant on duty to Sheffield where a specialist doctor was always available, using up valuable time.

But now the on-call consultant will be contacted by telephone and will then be able to communicate with nurses and other staff over a webcam, which will allow for an assessment and approval in minutes.

Thrombolysis delivers a clot-busting drug directly into a patient’s bloodstream, which can help minimise damage caused when they are suffering from a type of condition called ischaemic stroke, which account for more than 80 per cent of stroke cases.

Thromobolysis is not appropriate for the treatment of the less-common haemorrhagic stroke, which is not caused by a blood clot causing an obstruction of blood flow to the brain but by a ruptured blood vessel.

Sue Potter, Chesterfield Hospital’s stroke matron said: “We have set up webcam links between our five hospitals and the homes of our consultants who have been put on a rota and can be contacted during the night.

“If we get a patient who comes to our Emergency Department overnight, has a CT scan and we think they can be thrombolysed then we can contact the consultant.

“He will be able to see the scan and observe the clinical examination on screen, after which he can make a decision whether or not to thrombolyse.

“This is a tremendous advancement for us because it means that everybody in the region now has access to this treatment that has the potential to make an enormous difference to a patient’s recovery.”

Thrombolysis has been introduced in the region’s hospitals over the past few years with the first patient Chesterfield patient thrombolysed just before Christmas 2009.

The treatment can only be used within the first three hours of onset of symptoms for those who have had a stroke caused by a clot rather than a haemorrhage and is only generally licensed for people aged between 18 and 80 years.

Nursses said transfers to Sheffield had in the past “seriously cut into” the narrow time window available to reduce the devastating effects of stroke on patients.

Mrs Potter added: “Thrombolysis works by breaking up the clot that has caused the stroke and minimises the damage it causes to the brain by protecting the surrounding brain cells.

“The sooner we are able to administer it, the better the chance of recovery which can only be good for our patients.

“All of our nurses have been fully trained on the picture archiving and communications system that we use to display the CT scans and the commitment from nurses and consultants has been first class.

“The trial is due to last three months and we’re using that time to iron out any teething problems. We’re delighted and hope that it will make a real difference to our patients.”

The stroke team in Chesterfield see around 450 patients every year and medics said that up to 20 per cent of them will benefit from thrombolysis treatment.

The introduction of the telemedicine service is the latest in a series of stroke improvements at the region’s hospitals which saw the Chesterfield team move into a new, fully refurbished unit and therapy suite in 2011.