REMEDY : BNSSG referral pathways

Stroke

Checked: 28-09-2018 by vicky.ryan Next Review: 06-09-2019

Service Overview

Clinical Knowledge Summaries has useful advice on the principles of management of Stroke and TIA.

Patients with a suspected stroke should be referred immediately to an Acute Stroke Unit via the local Emergency Department (999).

Patients with a suspected TIA with ongoing neurological symptoms or signs when seen should also be regarded as suspected stroke and admitted as an emergency.

Patients with a suspected TIA where symptoms or signs have resolved - refer to the BNSSG TIA pathway

 

 

Stroke Services at UHB

Acute Stroke

Between 9am and 5pm a referring GP should call the stroke team on 0117 3427816 who will arrange an immediate CT head for them on arrival in A and E and consider thrombolysis if indicated.

After 5pm the patient should be referred via AGPT 0117 2449283 and sent to A and E via 999 ambulance.

If mild ongoing symptoms outside of thrombolysis window, not needing admission then discuss with stroke team in hours on 0117 3427816.

Non- urgent Referrals

There is no specific stroke clinic on e-referral at UHB so please send non-urgent referrals directly to the All-age stroke team or call the Single Point of Access tel. number for advice-  07887 452 814

Stroke Services at NBT

See link to Stroke for Clinicians section on the NBT website.

Acute Stroke

If CVA within thrombolysis window (6 hours) or of undetermined onset in last 24 hours or if patient woke with symptoms then send to A and E via 999.

If CVA with debilitating features outside of thrombolysis window then refer via AGPT 0117 2449283 as medical admission.

If CVA with mild ongoing symptoms outside of thrombolysis window then GP should give aspirin and refer urgently via TIA clinic.

Non- urgent Referrals

There is now a Neurology Vascular clinic accessible through e-Referral that is run from Southmead Hospital. The remit of this clinic covers strokes including long term complications, secondary prevention and investigation of aetiology.

Stroke Services at Weston

Acute Stroke

Patients with a suspected acute stroke should be referred immediately to an Acute Stroke Unit via the local Emergency Department (999).

Non- urgent Referrals

Weston have a stroke clinic that can be booked via e-Referral. This service is not for patients with suspected TIA who should be referred via the TIA pathway.

Community Stroke Services

Bristol After Stroke (previously Bristol Area Stroke Foundation) is a charity organisation that offers support for patients after a stroke in Bristol and South Gloucestershire. Health care professionals can refer to a Stroke Care co-ordinator. See website for  'Make a referral' page.

In North Somerset, community stroke services are provided by North Somerset Community Partnership.