North London Partners in health and care

UCLH and LAS pilot pre-hospital video conferencing to assess stroke patients

Pre-hospital video-conferencing will be used by the London Ambulance Service (LAS) and Stroke consultants at University College London Hospital (UCLH) as part of a pilot to enhance decision making for the treatment of patients suffering from symptoms of stroke and ensure they are transferred to the right destination for treatment in a single journey.

 To help with the response to the COVID pandemic and to ensure stroke patients continued to receive the best possible care, significant changes were made to the stroke pathway in North Central London. This included UCLH Hyperacute Stroke Unit (HASU) moving from University College Hospital to the National Hospital for Neurology and Neurosurgery at Queen Square.

The pilot scheme, which will run for four months, will see ambulance crews from the Edmonton Ambulance Station have access to a new pathway, where they will have 24/7 access to a Stroke Consultant through a secure video conference system in order to share assessment of patients, and based on the symptoms, decide where they should be transferred. 

This means:

  • Patients who are assessed as presenting with acute stroke will be taken to the HASU at Queens Square and the consultant will inform the HASU so that the patient’s arrival is expected
  • Patients assessed as experiencing a clinical event that is not an acute stroke or transient ischaemic attack will be taken to the nearest Emergency Department and the consultant will inform the local Emergency Department so that the patient’s arrival is expected.
  • For patients presenting with resolved events that are assessed to represent a Transient Ischaemic Attack (known as a TIA) the consultant will agree with the ambulance crew whether to take the patient to the local Emergency Department or to book the patient in to the local TIA clinic for urgent outpatient review.

The purpose of the video conferencing is to try to limit the number of unnecessary transfers in the Covid-19 pandemic, including limiting the unnecessary movement of COVID vulnerable patients and help reduce risk to the inpatient population.

In moving towards a more joined up approach to decision making for this complex condition, the new pathway aims to ensure patients receive the right care, in the right place and in the first instance. 

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