Lincolnshire Primary Care Trust has “more areas of weakness than strength” when treating stroke patients, according to research just released.
The research, carried out last year by the Care Quality Commission (CQC), used information from the government, local councils and local health services.
It also visited hospitals and care homes across the county and spoke to carers, family members and patients dealing with strokes.
From the information gathered, the CQC marked various areas of stroke care, out from the worst performing to the best performing.
Overall, Lincolnshire was marked as “Fair Performing” — although the care given is not the worst in the country, it has more weaknesses than strengths.
The result puts Lincolnshire just below the national average assessment score for strokes.
The areas Lincolnshire struggled most with were early discharge support, service access, support for carers, checking up on health a year after the stroke and end of life care.
However, the county was one of the best performers in the UK for involving stroke carers and survivors in the development of its stroke service.
It also faired well in giving patients care choices, a range of information, GP checkups, quick transfers from hospital to home and strong individual help.
Spokesperson for NHS Lincolnshire Sarah Howells said: “We welcome the CQC report on stroke services. This helps us to identify areas that we are doing well in and where we can improve services for patients.
“This report shows that we do particularly well on planning and managing stroke services and we achieved a very high score for involving stroke survivors in developing services.
“But we need to get better at specialist rehabilitation and helping people to stay healthy after a stroke.
“NHS Lincolnshire recently invested in a new Assisted Discharge Stroke Service from Lincolnshire Community Health Services.
“The service identifies patients in hospital following a stroke who are well enough to return home and benefit from home based rehabilitation.
“We will continue to work closely with patients, carers, social services and the Stroke Association to ensure we are investing wisely in stroke services that do improve quality of life for stroke survivors and their families.”
“Concerning” Variation
The research was conducted nationally over the last year, and results showed a concerning amount of variation between PCTs.
24% of areas assessed were unsatisfactory, 23% scored Fair Performing, while 26% got Better performing, and 26% scored Best Performing.
CQC Chief Executive Cynthia Bower said: “Stroke is the single largest cause of disability in adults and our evidence shows that early access to intense rehabilitation is beneficial to people’s recovery.
“Services have made improvements over recent years in the care provided in the hours and days that follow their stroke.
“It is vital that this momentum is maintained and that improvements are made in the care and support provided in the longer term.
“The level of variation is a concern, but the report also shows that the barriers to effective care after transfer home and around person centred care can be overcome and improvements made, which can help people to recover from, and cope with, life after stroke.
“We expect to see local health and social services working with stroke survivors, carers and representative groups to agree and implement a plan to improve services drawing on the results of our assessments of services in local areas.”
Spotted an error? Please notify us by selecting that text and pressing Ctrl+Enter.
The Lincolnite welcomes your views. All comments are reactively-moderated and must obey the house rules. Please stay on topic and be respectful of other readers.
The Lincolnite welcomes your views. All comments are reactively-moderated and must obey the house rules. Please stay on topic and be respectful of other readers.
This week there have been 1,940 positive cases of COVID-19 and 116 deaths in Greater Lincolnshire, as the region moves towards tier 3 restrictions next week.
Some 396 coronavirus cases and 27 COVID-related deaths were reported in Greater Lincolnshire on Friday.
The government’s COVID-19 dashboard recorded 286 new cases in Lincolnshire, 65 in North Lincolnshire and 45 in North East Lincolnshire, bringing the total number of cases in North East Lincolnshire to over 5,000 since the start of the pandemic.
It also registered 19 deaths in Lincolnshire, six in North Lincolnshire and two in North East Lincolnshire. These figures include deaths both in and out of hospitals as well as residents in hospitals outside the county. Deaths have now surpassed 800 since the pandemic began in Greater Lincolnshire.
NHS England also reported 13 new hospital deaths on Friday. Seven were at Northern Lincolnshire and Goole NHS Foundation Trust, five at United Lincolnshire Hospitals Trust and one in Lincolnshire Community Health Service hospitals. This takes the total number of hospital deaths in the county to 513.
On Friday, national cases increased by 16,022 to 1,589,301, while deaths rose by 521 to 57,551.
Lincolnshire cases up to November 27 (November 26 incomplete).
Meanwhile, Lincolnshire health bosses are in discussions with the government about a new COVID-19 testing centre in Skegness. East Lindsey has the fourth highest infection rate in England. The exact location has not yet been confirmed for the testing centre.
In national news, the UK’s R number has fallen to between 0.9 and 1 according to scientists. This means for every 10 people with coronavirus, they will go on to infect between nine and 10 people, suggesting the rate of infection is slowing nationally.
In Lincolnshire, the infection rate has already dropped on Thursday’s figures.
The region’s infection rates are dropping. | Data: GOV UK / Table: The Lincolnite
Coronavirus data for Greater Lincolnshire for Friday, November 27
25,427 cases (up 396)
15,770 in Lincolnshire (up 286)
4,619 in North Lincolnshire (up 65)
5,038 in North East Lincolnshire (up 45)
825 deaths (up 27)
541 from Lincolnshire (up 19)
142 from North Lincolnshire (up six)
142 from North East Lincolnshire (up two)
of which 513 hospital deaths (up 13)
271 at United Lincolnshire Hospitals Trust (up five)
11 at Lincolnshire Community Health Service hospitals (up one)
1 at Lincolnshire Partnership Foundation Trust (no change)
230 in Northern Lincolnshire (NLAG) (up seven)
1,589,301 UK cases, 57,551 deaths
DATA SOURCE — FIGURES CORRECT AT THE TIME OF the latest update. postcode data includes deaths not in healthcare facilities or in hospitals outside authority boundaries.
Lincolnshire County Council’s director of public health Professor Derek Ward said the government had used data from the peak of the county’s coronavirus infection between November 17-19 to make its decision, but that the latest figures already showed a massive improvement.
Professor Ward said people followed the rules, despite the peak in cases in the middle of November.
The government uses five key indicators make its decision and Professor Ward was confident the downward trend would continue.
The region’s infection rates are dropping. | Data: GOV UK / Table: The Lincolnite
Case detection rates in all age groups
Up to November 24, Lincolnshire’s infection rate was 232, compared to the England average of 209, said Professor Derek Ward.
Between November 17-19, the infection rate peaked at 308 — a difference of 76.
This is the figure that has been used the longest in determining the rate of coronavirus spread.
To improve this, Professor Ward said the usual messages of hands, face and space applied.
“It’s about trying to make sure people don’t catch COVID in the first place,” he said.
“So make sure you wash your hands for 20 seconds, make sure if you’re going into an enclosed space, or indeed, if you feel you’re walking through a busy street, that you’re covering the face, and keep at least two metres at all times from anybody outside your household.”
Case detection rates in the over 60s
For this more specific number, the current figure is 326 per 100,000 population, up from 281 in mid-November.
“The reason that’s important is because we know this is a disease that targets older people,” said Professor Ward.
“Older people are more likely to have a more severe form of the disease and they are therefore more likely to need NHS or hospital treatment, and more likely to die from it.”
In addition to hands, face and space, the key thing was for anyone who has symptoms to get a test “immediately”.
A map of Lincolnshire showing the seven-day coronavirus rates as of November 25. | Map: GOV UK
He said anecdotal evidence showed younger people might not get tested despite mild symptoms, but were then visiting relatives and possibly passing it on.
“Anybody who has any symptoms, no matter how mild, you must immediately isolate, don’t go for one last shop, don’t go for one last visit to your mum or dad.
“You can do a lot of stuff remotely, you can do it online, you can book shopping.
“There’s also support out there for anyone struggling,” he said.
The rate at which cases are rising or falling
This is a new indicator and health bosses did not have specific information to compare with government, however, Professor Ward said “overall our rates are clearly reducing.”
“‘It’s more a direction of travel than an actual figure,” said Professor Ward.
“Between November 17-19 we had the highest rates, and it’s been on a downward trajectory since then.”
He said he was expecting the trend to continue, especially considering the typical two-three week delay for the impact of the latest lockdown.
Positivity rate (positive cases as a percentage of tests taken)
Lincolnshire’s current positivity rate is 8.4%, down from around 12% at the most recent peak.
Around 25,000 tests have been carried out a week since early October, meaning around 2,100 positive tests a week compared to 3,000 previously.
However, health bosses do not want people to stop getting tests, in fact they want more to do so.
The criteria looks at percentage of positive tests rather than number carried out. Hence, if more people get tested and come back negative the positivity rate goes down.
| Photo: Steve Smailes for The Lincolnite
“The key thing that I want the people to do is if they’ve got any symptoms, no matter how mild, isolate themselves, get themselves a test,” said Professor Ward.
“The reason [government] are interested in this is that it’s a good indicator of two things. One, are you doing enough tests and two, are you targeting them?
“It’s really just giving us an indication of are we doing enough tests. If it’s going up, and it’s going up quite quickly, that’s when there’s a concern that we’re seeing an increase in actual community based infections.
“It’s coming down in Lincolnshire.”
Pressure on the NHS
United Lincolnshire Hospitals Trust bosses have confirmed they currently have 233 COVID patients and are using 74% of their hospital capacity.
The number has been steadily rising over the past month or so — on October 23 it has some 80 patients.
A ULHT spokesperson: “To help keep the pressure off of Lincolnshire’s hospitals so we can continue to deliver the best care to our patients, we would ask the public to please follow the latest government guidelines.”
However, bosses say the key message is that the NHS remains open and that people should continue to attend if they need it or if they have an appoointment booked.
Boston Pilgrim Hospital and Lincoln County Hospital.
The trust has not yet had to close its COVID-free site in Grantham, which other areas have chosen to do.
Professor Ward said there was no intention to discourage people from using their facilities.
“If people need the NHS, it is there for them whether it’s a very life-threatening 999 condition, or whether you just need a bit of advice and support, in which case NHS 111 online is your first port of call.
“Everything is still still open and available. Just consider whether you need it and if you’re not sure, check online or give them a ring.”
In conclusion, what can people do differently to help?
“I’m not sure it is doing anything differently,” said Professor Ward.
“It’s more of the same because we are seeing the benefits of people in Lincolnshire sticking by the rules.
“We just want them to keep doing that — it comes back to the same messages hands, face, space, minimise travelling if you can, work from home and minimise your contact with other people.
“That’s how we’ll bring the rates right down and then hopefully, we’ll be in a different position in the middle of December.”
The new tier allocations will be reviewed every two weeks from December 2.
Whatsapp
