The Cumbria and Lancashire Telestroke Network: saving lives with remote stroke diagnosis

The Cumbria and Lancashire Telestroke Network provides, for the first time, an out-of-hours stroke thrombolysis service. This ensures that anyone from Cumbria and Lancashire’s population of nearly 2.2 million can benefit from stroke treatment to reduce disability and death.

Prior to the implementation of this innovative service, each of the eight hospital sites involved, had an existing 9am - 5pm, Monday to Friday stroke thrombolysis service available. North Cumbria University Hospitals NHS Trust turned to Virgin Media Business to help establish and implement an out-of-hours Telestroke service so that care was available 24/7.

4,000 people across Cumbria and Lancashire suffer a stroke every year. But with the challenge of delivering specialist services to remote rural populations and the sharing of specialist stroke knowledge, the Trust was determined to find a way to close the geographic gap, and bring its patients the fast care they needed.

80 per cent of strokes are caused by a blood clot blocking an artery that feeds the brain. Patients with this type of stroke need rapid access to the blood clot busting agent, thrombolysis, which can reduce the symptoms of strokes and improve the rate of survival. This treatment can only be given to patients within four and a half hours of the onset of their stroke. A CT head scan must be performed to exclude the types of strokes caused by bleeding and the thrombolysis treatment can only be given following advice from a stroke specialist. The Telestroke service is helping to improve the speed of patient diagnosis – because when it comes to stroke victims every single second counts.

The Cumbria and Lancashire Telestroke Network remotely connects a specialist team of 15 stroke consultants, who provide ‘out-of-hours’ clinical advice from their homes across the county, to eight hospital sites. Each consultant is linked by a secure broadband connection to a ‘Telecart’ at the patient’s bedside. This enables a ‘two-way’ virtual consultation to take place, so they can see and speak to patients via innovative teleconferencing equipment, view CT scans and recommend appropriate treatment.

“The Telestroke service has transformed the way we deliver patient care. By harnessing the power of technology we’ve removed geographic obstacles to allow our staff to bring our patients cutting edge medical care. By taking the stroke specialists to the patient rather than vice versa, we’re saving critical – sometimes lifesaving – time, and giving the right treatment sooner. And, the new network also supports how healthcare is provisioned in the future – a truly exciting prospect,” said Dr Mark O’Donnell, Stroke Consultant at Blackpool Teaching Hospitals NHS Foundation Trust and Clinical Lead for the Cumbria and Lancashire Cardiac and Stroke Network.

The service requires big bandwidth, and high resilience to deliver fast communications - ensuring that the patient gets the treatment they need as quickly as possible. Virgin Media Business’ high-speed fibre optic network has provided its IP Virtual Private Network (IPVPN) which carries voice, video and data and offers a secure, flexible and reliable connection.

“To make this pioneering vision a reality, it was critical for us to invest in the right technology,” said Gus Hartley, Head of Northwest SIS at NHS North West. “Virgin Media Business is the only provider that could deliver the complete package that we needed, to give our doctors the tools they require to diagnose patients remotely. As a result, we’re in a position to meet some of the challenges our medical staff face and deliver high quality, cutting edge healthcare that will benefit both our patients and our staff.” Gus added, “Even patients in smaller, more remote hospitals will have access to the same specialist care – no matter where they are!”

The Telestroke service removes any barriers to quick treatment, such as travel times or out-of-hours care. Remote consultations and assessments mean that patients can be treated within the critical timeframe, getting them on the road to recovery faster than ever before.

Dr Paul Davies, Stroke Consultant at the Cumberland Infirmary in Carlisle said: “Thrombolysis is an effective clot dissolving treatment for the type of stroke caused by a blood clot, if given soon after the onset of symptoms. However, thrombolysis can carry a risk of bleeding and potentially make the stroke worse in some individuals; therefore the decision to give or withhold thrombolysis needs to be carefully weighed-up by an experienced consultant. The Telestroke service has enabled patients to obtain an opinion from an experienced stroke consultant outside of normal working hours.”

The Telestroke service has transformed patient care and is quickly becoming one of the blueprints for how telehealth services can save lives. Over five hundred advice calls and patient assessments have been handled by the doctors since its launch and, as a result, over two hundred patients have been given the life-saving treatment.

With the availability of 24/7 thrombolysis treatment, the Trust is expected to save £2.9 million over five years in patient treatment costs. In addition, the service is also expected to save the social services £3.3 million a year in residential and nursing care costs for stroke patients, making a total saving of almost £3.9 million a year.

Kathy Blacker, former Network Director of the Cumbria and Lancashire Cardiac and Stroke Network that coordinated the implementation of the Telestroke service, said: “By pooling our resources and taking advantage of new technologies, we can now ensure that every suitable stroke patient gets this fantastic treatment, wherever they are in the region and whatever time of day they are hit by stroke. Whilst telehealth doesn’t replace direct patient care, it offers a very real alternative for patients who need treatment fast.”