1. North Wales Trust Dr Salah Elghenzai

2. Demography Population 675,000 Population 675,000 1200-1500 Strokes /year in North Wales 1200-1500 Strokes /year in North Wales 250-350 TIA /year 250-350 TIA /year

3. 1200-1500 Strokes 350 die with in a 30days 350 die with in a 30days 400 discharged home 400 discharged home 450 further care 450 further care 120 will be candidate for Thrombolytic therapy 120 will be candidate for Thrombolytic therapy

4. In Theory Numbers are small to justify 3 acute units Numbers are small to justify 3 acute units Difficult to maintain Skills Difficult to maintain Skills Resource implications Resource implications

5. Options 1 Build large Neurovascular Centre to deliver Acute Stroke care Build large Neurovascular Centre to deliver Acute Stroke care TIA TIA Thrombolytic therapy Thrombolytic therapy Research and training Research and training

6. Option 2 Two Acute Centres supported with Smaller Two Acute Centres supported with Smaller Satellite units in the community The larger Centres deliver the Acute Pathway,Thrombolysis,training and education The larger Centres deliver the Acute Pathway,Thrombolysis,training and education Satellite units deliver the rest of the pathway lead by Community services Satellite units deliver the rest of the pathway lead by Community services

7. Options 1&2 For Debate (no option3) For Debate (no option3) Hard to swallow for all! Hard to swallow for all! Services should be planned with users in mind? Services should be planned with users in mind?

8. How to plan for ward North Wales Stroke Forum North Wales Stroke Forum Other strategic structure to engage the new Other strategic structure to engage the new North Wales LHB

10. Over to you?