Strokes: progressive stroke pathway

The progressive stroke pathway, produced by the National Advisory Committee for Stroke (NACS), sets out a vision of what progressive stroke care in Scotland should comprise.

3. Governance

This vision document will be supported by a refreshed Stroke Improvement Plan, the delivery of which will be overseen by the National Advisory Committee on Stroke, and monitored through the Scottish Stroke Care Audit and Scottish Stroke Improvement Programme.

While Scottish Government sets the overall policy direction and vision, NHS Boards have a statutory responsibility for the delivery of health care within their area. It is therefore important that NHS Boards seek to deliver the vision outlined within this document, giving an equivalent level of prioritisation to stroke services as outlined by Scottish Government.

To achieve this requires that:

  • NHS Boards have a clear management structure for stroke services relating to the whole patient pathway covering inpatients, outpatients and community services.
  • Each NHS board should identify a member of their Senior Management Team to be accountable for the delivery of stroke services.
  • Managed Clinical Networks (MCNs) should serve to coordinate professionals, services and organisations to ensure equitable, high quality clinical services.
  • MCNs should operate with clear clinical and operational leadership to connect services via service pathways.
  • Stroke services should coordinate across clinical, professional and service pathways, and be tailored to individual needs based on a range of personal, environmental and social factors.
  • Stroke services should capture data which reflects performance in real-time, to support quality improvement activities.
  • The NHS Board senior management team should take responsibility for ensuring that stroke services meet all important quality indicators within the Scottish Stroke Care Audit.
  • NHS Boards should, where necessary, work collaboratively with other NHS Boards in the delivery of services. This is essential in the delivery of thrombectomy, which requires a national approach, and for thrombolysis, vascular surgery and sometimes TIA and rehabilitation services, which often require a regional approach.
  • NHS Boards should work as part of integrated joint boards, alongside social care delivery partners and the third sector to deliver effective rehabilitation and supported self-management.



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