Stroke Campaign2017

MARCH 2017 HEALTHAWARENESS.CO.UK

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Stroke “We should be a nation that knows about its heart rhythm” Trudie Lobban of the Arrhythmia Alliance explores AF related strokes P4

NEW TECHNIQUES

The new surgery that could save thousands of lives P6 AFTER-STROKE CARE

Professor Tony Rudd on the need for further support in recovery P8

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IN THIS ISSUE

After stroke Professor Tony Rudd on why quick access to specialist care and treatment is key p8

Recovery Diane Playford explores the potential for stroke survivors to return to work p10

Future of imaging How a quick diagnosis of stroke though brain imaging technology can limit damage

Working together to fight stroke

I

We know that too many people wrongly believe a stroke could never happen to them. The alarming truth is that stroke is closer than most people think, says Juliet Bouverie, Chief Executive, Stroke Association.

t’s the fourth biggest killer in the UK and the single biggest cause of complex adult disability.

Not only this, but stroke also comes at a huge price - it costs our society around £9 billion a year.

Around 80 per cent of strokes are preventable.

One of the most potent risk factors for stroke is atrial fibrillation (AF) - an irregular heartbeat. Not only does AF increase the likelihood of having a stroke, AF-related Follow us

strokes are often more severe than other types of stroke and cause more deaths and greater disability. There are around 1.4 million people living with AF in England, yet over a third of them are undiagnosed. We need a step change in the way AF is diagnosed to save the NHS money, and prevent many thousands of people living with the disabling effects of stroke.

The good news is more people are surviving @MediaplanetUK

stroke than ever before.

The Act FAST campaign has helped people recognise the warning signs of a stroke and how to act.

But sadly, for the 1.2 million stroke survivors across the UK, too many have to wait weeks – in some cases, months – for the support they need for their recovery. The current National Stroke Strategy for England comes to an end in 2017 and the Government has no plans

Juliet Bouverie Chief Executive, Stroke Association

@MediaplanetUK

to renew it. That’s why we’ve launched our latest campaign, A New Era for Stroke, calling on a renewed national focus on stroke from the Government.

There’s no doubt that stroke devastates people’s lives. But with the right care and support, the condition can be prevented, and stroke survivors are able to rebuild their lives. If we rise to the challenge, together we can conquer stroke.

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Project Manager: Natalie Jaaskelainen E-mail: natalie.jaaskelainen@mediaplanet.com Head of Production: Faye Godfrey Business Development Manager: John Critchley Digital Manager: Chris Schwartz Social Media Coordinator: Jenny Hyndman Managing Director: Carl Soderblom Sales Manager: Alex Williams Designer: Juraj Príkopa Mediaplanet contact information: Phone: +44 (0) 203 642 0737 E-mail: info.uk@mediaplanet.com

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INSPIRATION PATIENT STORY

“I had no idea I was at risk”

By Nicola Cross, stroke survivor and volunteer for Different Strokes

I

had a bilateral thalamic stroke aged 40. It came entirely out of the blue, having never thought of myself as being at risk of having a stroke.

Initially at A&E it was thought to be a type of migraine and it wasn’t until four days later that it was diagnosed as a stroke following a MRI. Even though I had all the symptoms, I was regarded as too young to have had a stroke by doctors.

I spent four weeks in hospital, and I had many tests done to try to establish the reason but everything was negative. Then two months later I was admitted back into hospital suffering with Atrial Fibrillation (AF). It was decided then by the stroke consultants that indeed AF was most probably the cause of my stroke.

I was never aware of AF or had even heard of it. I knew on occasions I suffered from palpitations but put it down to stress and lifestyle factors. I also knew my heart raced at the gym and during exercise but again never linked it to anything serious affecting my heart. I was fairly fit, didn’t smoke, wasn’t obese.

I was put on an anticoagulant whilst in hospital, and later further drugs were added to regulate my heart rate. I later suffered a transient ischaemic attack (TIA), and due to continually being symptomatic further drugs were added, and I was offered an ablation procedure which I had in December 2016.

I’m reducing the risk of another stroke by taking anticoagulant treatment and hopefully the ablation procedure will be a success.

I still worry about having another stroke but there is support available. Surprisingly, there are a lot of younger people out there suffering from the long-term effects of a stroke.

Keeping your finger on the pulse Atrial fibrillation (AF) is a type of irregular heart rhythm, or arrhythmia, which increases the risk of stroke, known as an AF-related stroke, which is more debilitating than other forms of stroke. We can protect ourselves by knowing our own heart rhythm.

By Tree Elven

O

ver 500,000 people in the UK currently have undiagnosed AF. Its symptoms can include palpitations, pounding heart, and fainting, and it causes a 5 per cent annual increase in the risk of an AF-related stroke.

Yet it can easily be identified through a manual pulse rhythm check, and verified with a handheld mobile ECG device. Though we are all used to having our blood pressure checked when we go to a doctor or feel unwell, many of us may not realise that the heart rate is not the same as the heart rhythm.

“A doctor used to feel your pulse manually and have a stethoscope to listen to your heart’s rhythm,” says Trudie Lobban, CEO and Founder of Arrhythmia Alliance (A-A), which campaigns for heart rhythm to be

checked routinely through a simple manual pulse rhythm check. “Now the automatic blood pressure machines tell the doctor or nurse the heart rate, but not the rhythm.”

It is an important distinction, she says, because familiarity with the heart’s rhythm is the easiest, cheapest and quickest way to detect AF early and protect against stroke.

“All too often, people end up in A&E with a stroke and only then is the AF diagnosed.

If they had received an early diagnosis and appropriate therapy, they could have avoided the stroke and be leading normal lives.”

Therapy and treatment Once detected, AF needs therapy through anticoagulation to prevent an AF-related

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Know the signs. Understanding your heart rhythm could protect you from AF related stroke. Photo: Jesse Orrico

stroke, and treatment to manage symptoms and the heart rhythm.

This may be done by drugs or techniques such as ablation or cardioversion.

Many patients are still incorrectly given aspirin as an anti-coagulant therapy, but this is now proven not to work on its own in preventing an AF-related stroke.

Be aware at all ages AF incidence increases with age: 1 in 4 people over 65 will develop the condition. It’s never too early to start getting familiar with your own pulse so that you can sense when something is not right, says Lobban.

Trudie Lobban CEO and Founder, Arrhythmia Alliance

“We go into schools to teach children about this, and their homework is to go home and check their parents’, neighbour’s or grandparents’ pulses. Two children recently noticed irregularities in their fathers’ pulses who were diagnosed with arrhythmia as a result.”

You can learn online how to monitor your pulse. If you’re having symptoms, check it immediately, otherwise, once a week is fine, says Lobban.

If you notice irregularities – whether or not you’re having symptoms – make an appointment to see your GP. A-A is calling for a four-step management pathway for all patients with AF:

■■ Detect the abnormal rhythm

with a simple manual pulse rhythm check.

■■ Protect against AF-related stroke through anticoagulation (not aspirin).

■■ Correct the abnormal heart rhythm.

■■ Perfect the patient care pathway.

Lobban advises people to take notes into the appointment, and engage with the doctor or nurse when you are there – ask them to take your pulse. “We should be a nation that knows about its heart rhythm.”

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THROMBECTOMY: THE NUMBERS The surgery has offered much hope, however access has been limited is the UK lagging behind?

About 400 patients received thrombectomy treatment in England, Wales and Northern Ireland in 2015-16,but as many as 9,000 UK patients could have been eligible for the treatment

Brain is brain Clot-busting surgery can save thousands of lives - and thousands of pounds spent on stroke care.

By Ailsa Colquhoun

Because the treatment is not fully commissioned yet, almost a third of hospitals have no access to thrombectomy either on site or by referring to another hospital

Just 83 consultants in England, Wales and Northern Ireland reported they could undertake the procedure as of 2016 Source: Stroke Association

U

sing surgery rather than drugs to remove blood clots that cause stroke has the potential to restore a patient’s quality of life – and save thousands in health and social care costs, believes Dr Tufail Patankar, a consultant interventional neuroradiologist at Leeds General Infirmary. So, why do only a few hundred patients in England benefit from this procedure, he asks?

The procedure, known as mechanical thrombectomy, is used when the patient suffers an ischaemic stroke, or a stroke caused by a blocked artery. Ischaemic strokes are by far the most common type of

stroke, accounting for almost 85 per cent of all strokes. During a mechanical thrombectomy the surgeon uses specialist equipment to reach inside the blocked artery, and physically remove the clot – “a bit like unblocking a drain,” explains Dr Patankar.

Even though the procedure is still relatively new, mechanical thrombectomy is already considered a breakthrough. Compared to the previous ‘gold standard’ ischaemic stroke therapy of clot-busting drugs, mechanical thrombectomy gives the patient a longer ‘window’ in which to receive treatment and it also offers a better success rate: one in three patients receiving the procedure will go on to benefit.

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Innovative surgery. The surgeon uses specialist equipment to remove the clot from the blocked artery. Photo: Thinkstock

The ability to restore better blood flow to the brain and more quickly has important consequences for patients: it can mean the difference between a patient who is left severely disabled, bedridden, incontinent, and in need of constant nursing care and attention, and a patient with little or no disability. For the health and social care services that pick up the tab of chronic disability, the difference is a patient who can go home within 48 hours, or one who might need to stay in hospital for several months, and then need intensive social care – at a total cost of thousands of pounds.

Dr Tufail Patankar Consultant interventional neuroradiologist, Leeds General Infirmary

Dr Patankar believes that thrombectomy has the potential to reduce disability in a very wide range of ischaemic stroke patients, even in those whose brains are not expected to recover fully. His philosophy is “Brain is Brain”. But current availability of thrombectomy in England is very limited – to just a handful of centres and mostly during working hours – due to a combination of reluctance to adopt emerging technologies, funding concerns, and the need to redesign services so that patients are effectively managed into and out of specialist units offering this

procedure. He says: “What we should be working towards is a 24/7, 365-day service: strokes do not clock-watch!”

He believes things are changing, and his hope is that by the end of the year – as evidence for this procedure grows – there will be significant progress towards his goals. In systems where the cost of stroke to the whole health and social care system is recognised, mechanical thrombectomy is much more prevalent. For example, in Germany, several thousand thrombectomies are performed each year. Dr Patankar says: “We are lagging behind other countries and it’s not good enough.”

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NEWS

Knowing the signs of a stroke could save someone’s life.

F A S T

Facial weakness Has the face fallen to one side? Can they smile?

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Quick access to specialist care and treatment is key

Arm weakness

Can they raise their arms and keep them there?

Speech problems Is it slurred?

Time to call 999

If you notice any of these signs, call 999

As well as the signs above, other symptoms could also be due to a stroke, for example, sudden loss of vision or blurred vision, sudden weakness or numbness on one side of the body, sudden memory loss or confusion, sudden dizziness, unsteadiness or a sudden fall.

The faster you act, the better the chance of recovery.

Read more on nhs.uk/actfast

Photo: Thinkstock

By Ailsa Colquhoun

How well you do after a stroke depends on the care you receive while you’re having it, says Professor Tony Rudd.

Where is the best place in Europe to have a stroke? According to Professor Tony Rudd, a stroke consultant and NHS England’s National Clinical Director for stroke, it’s in the UK, where he believes stroke services have made “fantastic progress over the past 20 years”.

In a recent report looking at the quality of stroke services in hospitals across England, Wales and Northern Ireland, 50 out of approximately 130 hospitals received an A rating (first class service). By comparison, in 2013 no hospitals were rated A. A key difference is that today specialist stroke units are available in all hospitals that can accept a suspected stroke, giving patients quick access to specialist treatments and care. Hospitals are also getting better at discharging people as soon as they are medically fit, to continue rehabilitation at home and supported by specialists. UK stroke services have also become very good at capturing and sharing data, so experts like Professor Rudd can understand what a ‘good’ service should look like.

Professor Tony Rudd National Clinical Director for Stroke, NHS England

But, with the majority of hospitals still falling short of categorisation as ‘world class’, it is clear that more can be done, and according to Professor Rudd, this can be across the whole stroke care continuum. Among the changes he would like is greater use of technologies such as thrombectomy – which in certain stroke patients is used to suck out the blood clot blocking blood flow to the brain. But, “we are a nation of therapeutic nihilists,” he says, describing some clinicians’ attitudes to using this emerging technology.

Life after stroke Stroke units staffed by a high quality multidisciplinary team would also be welcome, he says, to bring skills in identifying and

managing the damage caused by a stroke, and in optimising a stroke patient’s general wellbeing to support faster recovery.

With the gift of a magic wand he would also improve longer-term rehabilitation. “We keep people in hospital far too long due to lack of community services,” he says, to huge economic and societal costs when patients and their families are prevented from returning to full productivity. In his view, local commissioning, which can result in huge variations in community service provision, does little to redress this situation.

And, finally, he’d also like to see patients empowered to take more of a role in their own stroke care, including by embracing healthy lifestyle messages and well man/ woman checks that potentially, could reduce the incidence of stroke by as much as 60-70 per cent. Should a stroke occur, Professor Rudd would like to see more acknowledgement of the need to act FAST - F: Face drooping on one side; A: Arm weakness; S: Speech difficulty; T: Time to call 999.“Because stroke is painless, some people don’t see it as an emergency.” But time is of the essence: some stroke treatments are only effective within the first four hours of a stroke occurring.

Commercial feature

One hour to save a life

By Ailsa Colquhoun

A thrombectomy can take less than 60 minutes to save a patient’s life.

After some thrombectomies, the difference to the patient is immediately obvious. Some regain speech or movement even before they are off the table. Sometimes, says Dr Jeremy Madigan, consultant interventional neuroradiologist, St George’s University Hospitals NHS Foundation Trust, a patient’s ‘feedback’ from a thrombectomy is somewhat “memorable”, particularly if they have experienced discomfort.

Doctors are rarely offended, he says, taking it as a welcome sign of promising neurological recovery.

In a thrombectomy the consultant makes a half centimetre nick in the groin area, from which a catheter (a thin, hollow tube) is

Dr Jeremy Madigan Consultant interventional neuroradiologist, St George’s University Hospitals NHS Foundation Trust

thread into an artery and up to the brain where the clot is located. Once the catheter is in place, a tiny mechanical device – just a few millimetres in diameter – is used to remove the clot from inside the artery. Latest generation

devices, such as phenox’s pRESET and pRESET LITE stentrievers, feature a unique design, engineered for stability and incorporating a wire mesh trap, which self-expands into the clot. This opens up blood flow and grabs the clot at the same time for removal. The whole procedure usually takes under an hour and with no other invasive procedures required - that’s why sometimes the patient is often only partially sedated throughout.

Of course, no medical procedure is without risk, which is why consultant neuroradiologists who carry out thrombectomies will have up to seven years specialist training in delivering the procedure. This is key to interpreting the pre-procedure diagnostic scans, choosing the most appropriate kit, such as the pRESET laser-cut stentriever,

and having the technique to avoid complications such a potentially fatal bleed.

When all goes well – when the right information is available at the right time and there is the right equipment for that particular patient’s needs – the patient may go on to make a full recovery, needing only paracetamol for minor post-operative pain. Currently, though, St George’s is the only hospital in England to offer 24/7 thrombectomies, which isn’t good enough, says Dr Madigan. “How well a patient does is directly linked to how quickly and well we get their clot out.”

Read more on phenox.net

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Advancing care through tech innovation

By Ailsa Colquhoun

Having the right product for the job is vital if stroke patients are to have the best chances of success.

Stroke specialists called neuroradiologists who deliver the often life-saving procedure of mechanical thrombectomy in patients with stroke face a number of challenges.

The procedure, which involves the physical retrieval of clots that are blocking blood flow to the brain, is rapidly becoming the gold standard treatment for patients with ischaemic (clot-related) strokes. Success rates for the procedure are high, with 50-60 per cent of patients making a good recovery.

This is why Dr Ian Rennie, consultant neuroradiologist at the Royal Victoria Hospital in Belfast, describes the procedure as “one of the most beneficial” in medicine today.

But it is a specialist procedure requiring great expertise and high

performance equipment; Neuravi, an Irish company dedicated to improving clinical outcomes for stroke patients, has taken a leading role in advancing thrombectomy technology. Having the right tools for the job can mean the difference between patients with potentially devastating strokes making a good recovery – and death or permanent disability requiring constant, expensive care. During one week at the Royal Victoria recently five strokes presented for thrombectomy, four of which were potentially devastating. But, thanks to the availability of equipment including the latest-generation Neuravi device EmboTrap® II revascularization device, Dr Rennie is happy to say all patients are now on their way home for rehabilitation.

Dr Rennie describes the EmboTrap II as a technological breakthrough. It offers a “nice balance” of gentle but effective treatment,

“Having the right tools for the job can mean the difference between patients with potentially devastating strokes making a good recovery – and death or permanent disability requiring constant, expensive care” he says, and a welcome advance beyond first generation products, which can be more challenging to maneuver in complex anatomy.

Neuravi performed extensive research into the nature of clots that cause stroke, and incorporated that learning into the design of the EmboTrap II in order to more effectively remove the range of clot types encountered when treating

stroke. Older devices may require more manipulation and may not be the best option for the type of clot they need to remove. However, EmboTrap II, with its patented stenttrap design, has been engineered to offer the physician much-needed flexibility, as well as a trap zone able to accommodate a broad range of clot types and lengths. Dr Rennie says Neuravi’s product engineering has taken a very welcome “scientific approach” to thrombectomy technology. Furthermore, compared to the costs of caring for stroke-related disability, the product represents “great value ” for health services.

Read more on neuravi.com

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INSIGHT

Show them the way home

Diane Playford President, British Society of Rehabilitation Medicine and Professor of Neurological Rehabilitation, Warwick Medical School

Working back to recovery

By Ailsa Colquhoun

R

eturning to work after a stroke is good for your health, the economy and the care system.

Up to eight in ten stroke survivors of working age could return to work with proper planning, believes Diane Playford, President of the British Society of Rehabilitation Medicine and Professor of rehabilitation medicine at the University of Warwick.

Half of stroke survivors are left with some form of disability, but with one in three stroke patients of working age it is important that those who want to return to work can do so, Playford says. Over 8 million people with a neurological condition are able to manage a daily routine.

“Working supports physical and mental recovery, boosts the economy and reduces people’s dependence on health and social care systems,” she says.

Careful planning should support stroke survivors back to work if they want this.

Playford says: “The conversation really needs to start early, where stroke unit teams can explore and manage the expectations that the patient, their families and the employer have.”

The reality is that a return to work can take six months or longer, particularly if intensive multidisciplinary rehabilitation is required. It should involve visits to the patient’s workplace to discuss concerns, and to support organisations to achieve adjustments that are reasonable under Equality Act legislation. The Business Disability Forum supports a disability-friendly economy because there are good commercial reasons to do so, says Playford. “Retaining valuable talent is good for any business.”

Photo: Thinkstock

By Ailsa Colquhoun

Early supported discharge has the potential to improve stroke recovery – so why isn’t it more widely available, asks stroke consultant Helen Rodgers, President of the British Association of Stroke Physicians.

How would you feel if your relative survived a debilitating stroke, only to be abandoned by the system after they left hospital? Would you be able to step in where care services don’t?

According to the Stroke Association, this is the reality for more than two in five stroke survivors, who rate the support they received for post-stroke fatigue, memory problems and emotional distress as poor.

Every year, around 152,000 people will have a stroke – but thanks to medical advances and the availability of specialist stroke services, only one in ten of these people (14 per cent) will die in hospital. But for the survivors, the aftermath of a stroke can include debilitating brain damage that renders them unable to wash and dress themselves, or to have problems with attention, concentration and, communication, reading and writing skills. Medical problems such as anxiety or depression or incontinence are also possible.

More challenging still is the fact

“Quality supported care can mean the difference between independence and dependence on others” that some of the consequences of stroke only become apparent once the survivor is on home turf and has to deal with a home or work environment that challenges their disability.

Returning home Much research has been done into the benefits for the patient and for the NHS of timely discharge once a patient is medically fit, but, according to Helen Rodgers, Professor of Stroke Care at Newcastle University and President of the British Association of Stroke Physicians, it is important to remember that going home after any in-patient stay “is a very scary time”. She explains: “Patients and their families can be uncertain whether they can cope at home.” That’s why she believes it is really important that patients and their families have the time and opportunity to discuss their return home with their clinical team, and raise any concerns about how they will manage when they get there. She says:

“There needs to be discussions about the changes and help which will be needed following a stroke, and there should be a clear plan agreed with patients and their families about discharge and ongoing care”.

Early supported discharge (ESD) is the term used to describe rehabilitation that is provided to stroke patients at home at the same intensity as inpatient care. Professor Rodgers believes there is no doubt that ESD benefits patients, their families and the NHS purse – although she points out it is important to remember that ESD is not about providing ‘cheap care’.

Unfortunately, for the majority of stroke survivors and their families, ESD remains a pipe-dream. A lack of community stroke specialist teams, postcode lottery commissioning and rehabilitation’s general lack of public profile mean that only around one in three eligible patients receives ESD. Professor Rodgers says: “There’s no reason why every locality cannot have these services – commissioners just have to want to have them – they are clinically effective and cost-effective - it’s a win-win situation. If ESD is not available to you locally, you’ve got to ask why not? Quality supported care can mean the difference between independence and dependence on others.”

T h E G OA L O F S T R O k E R E h A B I L I TAT I O N I S TO h E L P yO u R E L E A R N S k I L L S yO u LO S T W h E N S T R O k E A F F E C T E D PA R T O F yO u R B R A I N . S T R O k E R E h A B I L I TAT I O N C A N h E L P yO u R E G A I N I N D E P E N D E N C E A N D I M P R O v E yO u R Q uA L I T y O F L I F E. Rehabilitation for stroke and other forms of brain injury can assist someone to relearn basic skills such as talking, eating, dressing and walking, increase their strength, flexibility and endurance and regain as much independence as possible. The process of rehabilitation will be specific to the individual and will depend on their symptoms and severity.

People who have had a stroke have differing individual needs. This is a life-changing event affecting the family and social structure of the patient. Our flexible person-centred approach ensures all rehabilitation programmes are specific to individual lifestyles and requirements and are seen in the context of the person as a whole, incorporating the family dynamics and change in socials settings.

We provide a comprehensive, specialised, interdisciplinary rehabilitation service that equips patients with the skills, knowledge and information for them to return to their role in society with the highest feasible level of functioning.

We have a keen interest in market leading innovations. Our highly specialist teams work with the latest technology including Mindmaze which is an intuitive platform that incorporates virtual reality into and individuals pathway providing motivational training exercises in a way that’s new and exciting. This coupled with our latest introduction of the C-Mill treadmill and many more pieces allows us to have a complete array of equipment ensuring we’re pushing the boundaries with stroke rehabilitation and the goals achieved within.

T R E AT M E N T S Our Stroke Care Pathway is designed to facilitate rehabilitation and meet the standards identified by the National Service Framework for Long Term Conditions. The pathway aims to meet or exceed the standards for rehabilitation and care set by: The British Society of Rehabilitation Medicine (BSRM), the Care Quality Commission (CQC), and The British Society of Rehabilitation Medicine; National Clinical Guidelines for Stroke respectively.

Patients are admitted under the care of a specialist consultant in neurological rehabilitation. A multi-disciplinary team (MDT) with specialist expertise in rehabilitation co-ordinate the care of the patient, and every patient has a named key worker. The key worker is the principal liaison for the patient, family and MDT. Multi-disciplinary meetings evaluate a patient’s progress and adapt goal setting accordingly. We provide an on-going assessment of a patient’s progress in their abilities and level of independence in daily activities (i.e. dressing, walking etc). Individuals must be medically stable and able to participate in, and benefit from an intensive rehabilitation programme as their condition allows.

enquiries@royalbucks.co.uk twitter.com/RoyalBucks facebook.com/royalbuckinghamshirehospital royalbucks.co.uk

The Royal Buckinghamshire hospital, Buckingham Road, Aylesbury, Buckinghamshire, united kingdom, hP19 9AB. +44 (0) 1296 678800

CaptureStroke

A complete performance improvement solu on for stroke care Discharge Le ers and Summaries Role-based User Interfaces SMS and E-mail Alerts and No fica ons Real- me Excel integra on via OData Document Management Excep on Repor ng

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An intui ve overview of the pa ent’s treatment which reduces the duplica on of data.

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An at-a-glance view of all pa ents, offering users a summary of the hospital’s stroke ward.

CaptureStroke: Market Leading data collec on and care performance monitoring system for stroke services, CaptureStroke goes beyond the basic SSNAP dataset and retrospec ve repor ng to give real- me analy cs and at-a-glance understanding of pa ent status and stroke service performance throughout the pathway.

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Allows team leaders to assign user roles to easily manage and control access to the system.

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Allows users to view graphical representa ons of performance against locally pre-defined targets.

CaptureTherapy: Integrates with CaptureStroke and facilitates therapy care across mul ple disciplines and provides a quick clear and detailed view of therapy delivery and pa ent contact to support communica on between therapy teams.

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Interact with real- me data to enable service improvement and monitor key performance indicators (inc. SSNAP, SITS, ASI, CCG and locally required targets).

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Configure data collec on and work flow to align to local process.

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0191 280 4654 info@capturestroke.com @CaptureStroke www.capturestroke.com

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