Haringey Teaching Primary Care Trust
To receive a presentation from Vicky Hobart, Haringey TPCT.
Minutes:
The panel received a presentation from Vicky Hobart, Public Health Consultant: Head of Health Inequalities and Partnerships, Haringey Teaching Primary Care Trust.
There is currently an ambitious national vision for strokes; this is set out in the National Stroke Strategy.
Pathways are complex and involve a range of providers.
Needs assessment data is not currently available. Data requirements for this review therefore need to be discussed.
Local data needs to be analysed, interrogated and bench marked.
The Well-being Strategic Framework sets out the strategic approach to health issues in Haringey.
There is currently approximately 8 years difference in life expectancy between the East of the borough and the West of the borough.
§ Life Expectancy is 71yrs in the East and 77.6yrs in the West.
§ The gap is particularly wide for men.
§ These figures are based on a person at the point of death i.e. people who die in Haringey.
Younger people suffering strokes is also an issue in Haringey.
An issue in Haringey is that of premature deaths – it is higher than would be ‘expected’ for the demographics of the population.
§ Need to look at comparisons with other areas of a similar demography for strokes.
There are a number of risk factors which include the utilisation of and access to services, lifestyle and quality of housing.
Thought needs to be given as to how we can effectively intervene.
A stroke IS a medical emergency and needs to be treated as such.
There are a number of effective interventions for someone who has had a TIA e.g. thrombolysis.
Strategic context
The National Stroke Strategy is a culmination of all previous data.
The UK has comparatively expensive stroke services with comparatively poor outcomes.
§ There is avoidable mortality.
Measuring performance is a challenge.
North London Collaborative Commissioning Group
Haringey TPCT is the lead commissioner for the North Middlesex Hospital. Islington PCT is the lead commissioner for the Whittington Hospital. The PCT’s are collaboratively looking at services.
E.g. ambulances are not currently commissioned to take suspected stroke patients to a specific hospital. This is an area that is currently being looked at.
Primary Care intervention is about reducing the clinical factors.
There needs to be a cautious approach to looking at Quality Outcomes Framework (QOF) data as the statistics do not necessarily capture all relevant stokes e.g. when someone has a TIA. They only capture ones where the GP is made aware that a stroke has occurred.
Consideration should be given to Stroke registers being held by a wider audience.
There is not currently lead GPs for Stroke Care in Haringey.
Pathways
Well-being
§ Campaigns and information (including smoking cessation, physical activity, alcohol reduction, obesity etc).
§ The Well-being Strategic Framework outcomes are being are being delivered across the partnership including all Thematic Boards e.g. the Enterprise Board is helping people get back into employment.
§ The Well-being pathway is about the environment that we live in – schools, education, social marketing, community development.
Primary Care
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