THE decision on whether or not the South West Acute Hospital (SWAH) would retain its Stroke Unit has been pushed back until 2023.

More than three years ago, the Department of Health unveiled its radical plans to reshape stroke care across Northern Ireland.

Under the Reshaping Stroke Care plans, it was planned to establish dedicated Hyperacute and Acute stroke units.

There were six options revealed for the provision of specialist emergency stroke care in Hyperacute Stroke Units (HASU), with the SWAH only included in two of the options.

The other four options would see the closure of the Stroke Unit at the SWAH.

It was planned this would have been completed by 2022; however, on Monday, the Health Minister Robin Swann released a new process which sees the decision pushed back until the summer of 2023.

‘Revised approach’

The Reshaping Stroke Care Action Plan stated that instead of the 2022 deadline the Department of Health intends to “commence a revised approach to evaluate options for the introduction of hyperacute stroke care”.

The action plan stated: “It is clear from the public consultation that there is significant concern about some of the assumptions behind the options outlined in Reshaping Stroke Care, and consequently with the proposals themselves.

“The Department also recognises that demographic changes are likely to drive increasing demand for stroke services, which will need to be factored into any future hyperacute stroke configuration.

“We also recognise that many of the assumptions underpinning the original options presented in the Reshaping Stroke Care consultation will now need to be revisited.”

Range of factors

The new approach intends to consider a range of factors not included in past analyses, including the impact of demographic changes on future demand, stroke mimics, evolving clinical guidance and the feasibility and cost of implementation.

External expertise will be appointed to carry out the above analysis, evaluate the options and deliver a detailed assessment of potential hyperacute stroke sites.

In the Stroke Action Plan, it is hoped a Stroke Hyperacute Project Board will be established by July and the external expertise will be appointed in autumn.

By next summer, the preferred option will be identified and submitted to the Health Minister for decision.

Significant advances

Professor Ronan O’Hare, Assistant Medical Director at the SWAH, said significant advances, particularly in telemedicine, means another look is needed at the provision of stroke care to get the best possible outcomes for patients.

“There is much more significant advances, particularly in telemedicine across the UK, and you don’t necessarily have to be based in a hospital to diagnose a stroke.

“So it’s done with clinical findings on the ground and confirmation of that via CT scanning, and we already have consultants in this hospital who work in the SWAH who diagnose strokes here who are, via telemedicine, helping other Trusts across the province and the UK in diagnosing their strokes.

“The provision of stroke care has been superceded by telemedicine and therefore it deserves another look at to get the best possible outcome for patients.

“And that is an example of dynamic workforce changes in innovation, and again we are at the forefront of that.”

19,500 responses

The publication of the stroke care action plan follows the Reshaping Stroke Care public consultation undertaken by the Department of Health in 2019.

More than 19,500 responses were received to this consultation. The public consultation analysis was also published on Monday. The pandemic regrettably delayed the decision-making on the consultation, but I am very pleased to be able to publish the action plan. It sets out an ambitious, multi-year programme of reform,” Minister Swann said.

“While supportive in principle of the development of Hyper Acute stroke care, I believe more work is needed before decisions on the locations of HASUs and ASUs can be made.

“In particular, the evidence base that underpinned the 2019 consultation needs to be updated and enhanced, including on the implications for stroke care of our ageing population.”

You can view the Stroke Action Plan at