National Advisory Committee for Stroke minutes: March 2021

Minutes of the meeting of the National Advisory Committee for Stroke (NACS) on 29 March 2021.

Attendees and apologies


  • Prof Martin Dennis (MD)
  • Kylie Barclay (KBa)
  • Elizabeth Barrie (EB)
  • Mark Barber (MB)
  • Sheena Borthwick (SB)
  • Alan Cowie (ACo)
  • Katrina Brennan (KB)
  • Jesse Dawson (JD)
  • Karen Garrott (KG)
  • Jackie Hamilton (JH)
  • Craig Henderson (CH)
  • Prof Peter Langhorne (PL)
  • Therese Lebedis (TL)
  • Neil Muir (NM)
  • Mark Smith (MS)
  • Susan Wallace (SW)
  • John Watson (JW)
  • Fiona Wright (FW)
  • John Wilson (JW)

Items and actions


The Chair welcomed everyone to the virtual NACS meeting, particularly John Watson, the new Associate Director for Scotland at the Stroke Association who was attending his first meeting. Attendees introduced themselves.

The Chair informed the group that Mark Smith was soon to retire and was attending his final NACS meeting. Mark had been a member since the group’s inauguration and on behalf of everyone the Chair thanked Mark for his valuable contribution and service to the group, particularly around the rehabilitation agenda.

Minutes of previous meeting (02/11/2020) – NACS/November2020/minutes

Committee accepted the minutes.

Action point update from previous meeting (02/11/20) – NACS November2020/action summary

MD talked through the actions in the circulated action point update paper noting those cleared and asked for updates on those ongoing:

  • Neil Muir, Therese Lebedis, Fiona Wright - forward NACS Sub-Group memberships to secretariat. MD confirmed that circulation lists were passed to Secretariat in November 2020
  • NACS professional group representatives - provide updates for NACS on professional groups going forward: SSNF, SSAHP, Forum SSPF, and Stroke Research Network. MD confirmed that updates had been received and circulated and were on the agenda at item 6
  • NACS professional group representatives - nominate a deputy to secretariat. MD informed the group that progress had been made identifying the deputies for the SSAHPF, SSNN, SSPF and the Scottish Stroke Research Network
  • Secretariat - confirm NACS meeting dates for 2021. MD noted that the next meeting of the group was scheduled for 2-00pm, Monday 27 September 2021

Stroke Programme for Government (PfG): progressive stroke services draft

MD set out the background to the draft circulated covering the PfG commitments including the review of the current stroke care bundle, scoping out, and defining what a progressive stroke service looks like. It was intended that the draft paper encapsulated the reviews done to date and to set out the next steps for future direction. Thanks to the Chairs and the Subgroups were expressed for their contribution. The first part of the paper provided an introduction to stroke services, part two included methods on the stroke services review and part three aimed to inform a view on a future trajectory.  

The group discussed underpinning guidance regarding staffing levels and rehabilitation and TL agreed to raise this with the Rehabilitation Sub-group. There was further discussion on the potential for further editing and electronic formatting. MD confirmed that the National Stroke Voices (NSV) panel would be asked for their views after a presentation to a panel at their next meeting after their 7 April meeting. KG and AC agreed to arrange agenda slots for future NSV meetings and after liaison with Scottish Government colleagues, a further draft would be worked on for the end of May. 

The membership agreed not to circulate the draft out-with the NACS and its subgroups.

The group agreed to forward comments and suggestions on the draft to Prof Dennis by 12 April.


  • arrange presentation/discussion agenda slots on the PfG draft document for the NSV panel beyond the next meeting – Karen Garrott, Allan Cowie
  • forward comments/suggestions on the draft PfG document to Prof Dennis by 12 April - all

Scottish Stroke Care Audit (SSCA)

NM confirmed that the National Annual meeting had been scheduled for 2 September. The annual report was scheduled for publication on 29 June. Data linkage work the ambulance service was progressing. The organisational audit had been sent to Health Boards with a deadline of 31 March.  The next meeting of the writing group had been scheduled for 23 April. Monthly reporting was being improved to allow increased flexibility with use of the RedCap tool. MB confirmed that a COVID-19 would feature in this year’s report.

Scottish Stroke Improvement Plan

KB reported that the improvement work was being progressed in light of the PfG components and Health Board reviews were being scheduled to focus on this.

National Stroke Voices update

KG reported that interviews to recruit for the panel had taken place in January and Prof Dennis had presented to the group at their first meeting on 24 March. A second meeting had taken place on 17 March. A third meeting scheduled for 14 April would have rehabilitation on the agenda. The first two meetings had a focus on governance with next steps to look at the election of a Chair and Deputy Chair. There was discussion on NSV representation on NACS with examples from other Scottish Government committees. It was agreed that once the process to identify a Chair and Deputy had been completed, an invitation to attend the September meeting of NACS would be progressed.


  • progress an invitation for NSV representation at the September meeting of the NACS once a Chair and Deputy for the NSV have been confirmed - Karen Garrott, Allan Cowie

Professional groups - update

EB talked on the update paper provided for the Scottish Stroke Nurses Forum (SSNF). The Forum had been meeting virtually and a workplan was in place covering 2017- 22. Current projects included taking forward thrombectomy work on the nursing side, the launch of a career framework or stroke nurses and updating work on STARS. Last year’s conference had been cancelled and in 2021, planning was for a virtual conference. The results of physiological monitoring research was being awaited. Members were also engaged on work to assess the impact of COVID-19.

MS updated on the Allied Health Professionals (AHP) Forum, referring to the circulated paper. Meetings were taking place quarterly. The 2020 conference had been cancelled; however, a shared conference with the SSNF was being progressed. A survey on the impact of COVID-19 on rehabilitation services was being developed with support from Napier University. A number of research projects were being supported by the Forum. The AHP Forum were represented on planning committees and membership had been confirmed at 542.

JD reported to the group on the Stroke Research Network and confirmed that recording of trial recruitment had changed to a manual process and COVID-19 had negatively impacted enrolment over the last year. Work on carer involvement was reported as progressing well. Discussion on thrombectomy had taken place with colleagues in England. A strong portfolio was reported for the coming year with budget unchanged. 

JH summarised the update paper on the Scottish Stroke Psychology Forum (SSPF) circulated to the group. The new National Model of Psychological Care in Stroke Services had been presented on at the Rehabilitation Sub-group, also circulated. It was a significant piece of work and JH asked the group to send on any questions and comments they had. Challenges had been identified regarding data and NM had confirmed he would work with the SSPF to progress. SSPF members continued to provide input into the STARS modules.


KB updated the group, reporting progress. The Thrombectomy Advisory Group had met on the 25 March and will be meeting every six weeks. Moving forward, regions would take on a greater role in progressing work. The business case for 2021/22 had been passed to the Scottish Government. A meeting had been scheduled for later in the week to discuss the governance around this. Regarding the roll-out, seven patients had been treated at Ninewells. A substantial capital requirement had been agreed for the programme, progress with INR appointments had been made. Provision of CTA out-of-hours was being examined with artificial intelligence support. Education sessions run by Prof Dennis had been found to be very useful and a similar approach for nurses was being progressed.

KB informed the group that hospitals knew of the timeline and preparatory work to support this was ongoing. MD also noted that STAT+ training for nurses was progressing via Teams. Three hundred and fifty certificates for the STARS hyperacute module had been issued across Scotland. MS noted that he had begun a conversation with colleagues on the potential impact of thrombectomy on case mix.


MD informed the group of moves in England to redraft of the Royal College of Physician guideline following funding support by the Stroke Association. 

The group raised no other business.

Next meeting

The next meeting was scheduled for 2-00pm Monday 27 September. 


  • NACS March 2021/action 1 - arrange presentation/discussion agenda slots on the PfG draft document for the NSV panel beyond the next meeting - Karen Garrott, Allan Cowie
  • NACS March 2021/action 2 - forward comments/suggestions on the draft PfG document to Prof Dennis by 12 April - all
  • NACS March 2021/action 3 - progress an invitation for NSV representation at the September meeting of the NACS once a Chair and Deputy for the NSV have been confirmed - Karen Garrott, Allan Cowie
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