National stroke strategy launched after pandemic delay

The delay to the introduction of a national stroke strategy, due to Covid-19, allowed for the consideration of certain elements which were not prioritised in the plan before the pandemic, according to the HSE Clinical Lead for the area. 

The National Stroke Strategy 2022-2027 was launched on 29 October after a two-year delay in implementation. 

Prof Rónán Collins told the Medical Independent that although the strategy was ready in 2020, it could not be advanced due to the condition of the healthcare system during the pandemic. 

“The HSE and the Department of Health… couldn’t consider a stroke strategy,” he said. “To be fair, I wasn’t pushing it too hard in 2020…. I was back-to-the-wall fighting to just keep stroke units open and keeping the staff from being redeployed.” 

However, the delay allowed for greater exploration into telehealth and remote care, which are key parts of the strategy. 

“We realised that early supported discharge [ESD] can now actually reach a lot more people [and] that we can use a lot more telerehabilitation,” he said. Senior Physiotherapist at Cork University Hospital, Ms Marie Condon, a colleague of Prof Collins, co-authored a study in the October issue of the Irish Medical Journal, which found that stroke survivors receiving ESD were equally satisfied with telerehabilitation. 

As part of the rehabilitation aims of the strategy, a stroke key worker is to be appointed to each Community Healthcare Organisation. However, “we learned during the pandemic that some of this can be provided very effectively online, through courses delivered online, and practical support online,” according to Prof Collins. 

This service would be modelled on the Irish Heart Foundation’s stroke support line, although the strategy is still exploring options in this regard. Prof Collins noted that most strokes occurred in older people and not everybody in these age groups is digitally enabled. 

The strategy, launched by the HSE and the RCPI, focuses on four key areas: Stroke prevention; acute care and cure; rehabilitation and restoration to living; and education and research.