1. The Work of the Stroke Services Expert Panel Stroke Regional Workshops November 2008 Dr Paul Tromans Chair of Expert Panel

2. Content of Presentation Setting the Scene to Strokes in Wales Stroke Services Improvement Project Targets and Ministerial Priorities Funding Letter Establishment and Membership of Expert Panel First Meeting 24 June Second Meeting 4 September Allocation letters from WAG

3. Strokes in Wales RCP Sentinel Audits Mortality

4. Stroke Services Improvement Partnership Established at request of WAG Partnership between –NPHS –Wales Centre for Health –NLIAH –Stroke Alliance Formed to support stroke services improvement

5. Targets and Ministerial Priorities WHC (2007) 058 Implementation of National Standards for Stroke Services in Wales Urgent Action by March 2008 LHBs and Social Services in each region working together….…must have submitted action plans for the delivery of NSF Standards. Priority must be given to putting stroke units in place.

6. Targets and Ministerial Priorities WHC (2007) 082 Improving Stroke Services: A Programme of Work all patients suspected of or confirmed as having had a stroke must be admitted to dedicated and co-located stroke beds staffed by a specialist multi- disciplinary acute medical and rehabilitation stroke team – by March 2009

7. Funding Letter Letter from WAG 14 March 2008 Allocation by Minister of £2.5M for stroke services from 2008-09 Funding allocated notionally by region Requires regional spending plans in support of the regional action plans by the end of April 2008 Announces that Stroke Partnership is to establish Expert Panel to review the regional action and spending plans and make recommendations to WAG

8. Establishment and Membership of Expert Panel Established by the Stroke Partnership at the request of WAG Membership Chair: Dr Paul Tromans – Director of Health and Social Care Quality, NPHS Dr Tony Rudd – Consultant Physician in Stroke Medicine, Guys & St Thomass, Chair of Intercollegiate Stroke Working Party, RCP Prof Derick Wade – Chair of Rehabilitation, Kings College, London Dr Avril Drummond – Associate Professor of Rehabilitation, University of Nottingham Dr Anne Freeman – Gwent NHS Trust, Lead Physician Stroke Partnership Andrew Lewis – Director of Service Improvement, NLIAH Trish Hughes – Stroke Association Dr Aled Williams – GP, Llandeilo Alun Lloyd, Director of Finance, Velindre NHS Trust

9. First Meeting of Panel 24 June Strongly supported the priority as being acute stroke units Unable to recommend accepting the spending plans Plans were collation of local plans, not regional plans Plans covered entire stroke pathway Where the priority of stroke units was targeted, insufficient detail to support 2 nd round of plans requested, targeted at acute stroke units – guidance supplied Support offered from Project Team to assist

10. Second Meeting of Panel 4 September Plans more regionally focused Plans targeted at acute stroke units Bids to develop Regional Networks rejected All other recurrent expenditure bids accepted Flexible approach recommended Conditions attached relating to stroke co- ordinators and consultant sessions Guidance given on non-recurrent use of Year 1 slippage money Report & recommendations submitted to WAG

11. Allocation Letters from WAG Letter 14 October –Allocated funding regionally in line with original notional allocation, and based on Expert Panel Report –Requested annual report on the use of the funding Letter 20 October –Enclosed copy of Expert Panel Report –Drew attention to flexible approach and to conditions –Announced that Year 1 slippage not available for non- recurrent spend