The Oxford Academic Health Science Network (AHSN), in collaboration with stroke leads for the Getting It Right First Time (GIRFT) programme and with the support of the British Association of Stroke Physicians, has issued guidance to support stroke services during the COVID-19 pandemic. The new guide, Restoration and recovery of stroke services during the COVID-19 pandemic, is intended to help stroke teams across England deliver high-quality care in the restoration and recovery phase of the COVID-19 pandemic.
The response to the COVID-19 pandemic caused significant disruption to non-COVID clinical services. Stroke services were no exception, and underwent a period of rapid change to cope with consequences of the pandemic such as reduced admissions, fewer referrals for transient ischaemic attack (TIA), COVID-19 outbreaks, and staff sickness. New ways of working were developed that complied with requirements to minimise face-to-face contact between patients and healthcare professionals while maintaining the provision of high-quality stroke care.
The new guide—which is a follow up to the May 2020 publication Adapting stroke services during the COVID-19 pandemic: an implementation guide—assesses the impact of these changes to the stroke pathway and provides practical recommendations on the resumption of stroke services. Based on discussions with stroke teams, the guide addresses common themes such as:
- staff wellbeing—returning to sustainable ways of working while recognising the psychological impact of delivering care during a pandemic
- efficiency—acknowledging that a reduction in efficiency is inevitable because
- enhanced cleaning and use of personal protective equipment (PPE) are required
- virtual clinics, although highly effective, can take longer than face-to-face methods
- COVID-19 testing in the emergency department for staff and patients
- review of TIA services to ensure their continuation via remote methods
- infection control measures to reduce the spread of COVID-19
- transfer of care between settings—balancing the need for rapid supported discharge to reduce the risk of hospital-acquired infection and protecting community settings
- early supported discharge and community rehabilitation—offered alongside face-to-face contact (with PPE and infection control precautions) to maximise the rehabilitation potential of stroke survivors.
The guide also highlights new ways of working that have been beneficial for patients and staff and should be continued after the pandemic. In addition, real-life solutions to the challenges posed by the COVID-19 pandemic are shared in useful case studies that disseminate good practice, and readers are invited to contribute to this evolving guide via the case study form.
Professor Gary Ford, Chief Executive of the Oxford AHSN, said: ‘This has been a joint effort between the GIRFT stroke leaders and the Oxford AHSN team, bringing together great examples of innovation and improvement across the stroke pathway from all over the country. We hope stroke teams will continue to share best practice as we move further into the restoration and recovery phase of the pandemic.’
Practical tips on how stroke teams have risen to the challenge of COVID-19 will be discussed in a forthcoming webinar, Supporting stroke services through the pandemic, for which registration is free. The webinar will feature national stroke leaders and a patient perspective, and will take place on Thursday 16 July 2020 at 5:00–6:00 p.m. BST.