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National Review of Patient Flow (Stroke Pathway)

In our operational plan for 2021-22, we committed to a reviews programme that takes into consideration the risks and challenges facing health services as they continue their response to, and recovery from, the pandemic.

Ineffective and inefficient patient flow can have a significant impact on the quality and safety of patient care. Consequently, we wish to gain a greater understanding of the challenges that health services face in relation to how patients flow through the healthcare system, and to test if arrangements for patient flow are robust. We will also consider how NHS Wales’s services address peoples’ access to acute care at the right time and if care is received in the right place, by people with the right skills, through to timely discharge from hospital services including transfer care to other services.

As a result, we have decided to undertake a national review of Patient Flow. In order to assess the impact of patient flow challenges on the quality and safety of patients awaiting assessment and treatment, we have elected to focus our review on the stroke pathway. We want to understand what is being done to mitigate any harm to those awaiting care, as well as understand how the quality and safety of care is being maintained throughout the stroke pathway.

Our research, stakeholder and third sector engagement has helped inform the main questions which our review will seek to answer. That being:

  • How are healthcare services ensuring that timely access and treatment is provided to patients on the stroke pathway?
  • What steps are healthcare services taking to ensure that safe and effective quality care is provided at each stage of care, minimising the impact of delays?
  • What measures are healthcare services taking to ensure that patients are able to be discharged effectively, and safely from hospital services?

Throughout the review we will explore:

  • The experiences of people accessing care and treatment for stroke, focussing on key aspects of patient flow, at each stage of care, from assessment through to discharge
  • The impact that patient flow can have on outcomes for patients.

It will also explore:

  • The processes in place for managing patient flow through healthcare systems
  • The patient journey through the stroke pathway

We aim to publish the review at the end of 2022. A copy of the terms or reference for the review is attached below.


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