Frequently asked questions (FAQs) 

How are patients referred to the HASU?

Stroke patients come to the UCLH HASU from one of the following sources:

  • 999 call via ambulance from home or GP
  • A&E without HASU
  • UCLH A & E 
  • Inpatient having stroke on the ward at a district general hospital

Non-stroke attenders, i.e. TIAs or ‘stroke mimics’ will be seen on the HASU and then discharged to an appropriate place e.g to home or another ward in the local hospital /UCH.

How should GP’s refer a patient with a suspected stroke?

If stroke symptoms are <4.5 hours onset call 999 immediately as thrombolysis might be possible. LAS will take to the nearest appropriate HASU.

For symptoms with a longer history of onset contact the HASU registrar on 07753739286 for advice on the appropriate referral pathway.

To arrange a new patient non urgent stroke out patient appointment please contact the bookings team call centre on 02078298777 (M-F 9-5).

If your enquiry relates to a follow up appointment that should have already been made please contact Teresa Feeney on 0845 155 5000 ext 72 3416 or the clinical nurse specialist on 07943 871 067

What happens on a HASU?

Patients are brought in via the ambulance to A&E and those that are considered suitable for thrombolysis have an immediate CT scan on arrival. Once the decision to thrombolyse or not [i.e. give clot busting drugs] is taken, the patient receives the bolus thrombolysing drug and then moves to the HASU on T7 at UCH.

After an average of 72 hrs in HASU, patients move to their local stroke unit, or are sent home possibly with input from early supported discharge teams where appropriate.
 In the HASU, there is multidisciplinary input from a highly skilled team which includes physiotherapists, occupational therapists, speech & language therapists, skilled nurses, and dieticians and a dedicated team of 12 consultants - six from the NHNN and six from other hospitals across the sector – North Middlesex Hospital, Royal Free Hospital and Barnet Hospital.

This collaborative model of ‘linked consultants’ creates closer working across the sector. This established link means a greater degree of continuity of care for patients as they are transferred to the local stroke units in these hospitals when they leave the HASU (after approximately 72 hours). It also makes the ‘transfer’ process quicker and easier.
This rota model has been cited as a success by the North Central London Stroke Network who are recommending it to other sectors in London.

We also benefit from expert opinions from neuro radiologists at NHNN and UCH site and have close working relationships with the neurosurgical and vascular teams within UCLH to ensure our patients can access surgical pathways when appropriate.

We also rely on the services of the excellent radiography, vascular, general medical, A & E, ITU at UCH and NHNN and the pharmacy teams to ensure our patients receive the best possible care across the whole of their care pathway.

Why was UCLH chosen to become a HASU?

We are recognised for best practise, service development and clinical expertise for stroke. The most recent organisational stroke audit by the Royal College of Physicians placed UCLH second in the delivery of stroke care across the whole of the UK.

What’s different about the UCLH HASU?

Our HASU is a collaborative venture with UCL Partners and The Stroke Network. We bring together the clinical and research expertise from organisations like UCLH, Royal Free, UCL, North Middlesex and Barnet. This means that patients can access both the best in clinical care and the latest in translational research in stroke.

Why is the HASU at UCH not NHNN?

Stroke patients often come in via ambulance to A&E which is based at UCH. Stroke patients also have often have other medical problems so need access to general medicine and surgery teams at UCH.

What’s the difference between a stroke unit and a HASU?

In London patients with a stroke will initially be admitted to one of eight HASUs, after an average of 72 hours they may be discharged home or transferred to their local stroke unit for further investigations and acute rehabilitation. Patients within London are allocated to a stroke unit on the basis of their postcode, this allows patients access to local services.

How do I know what my local stroke unit is?

http://www.londonsulookup.nhs.uk/

Will all stroke patients go to a HASU?

From July 19th 2010 acute stroke patients within London come to UCLH HASU or the nearest HASU to where they have collapsed. If the referral is for a stroke that occurred several days ago, then a clinical discussion will occur before the patient is moved. Our stroke registrars are available 24/7 for advice via the switchboard.

What happens when patients are ready to leave the HASU?

Patients from the UCLH HASU can go to –

  • The stroke unit in the sector that is closest to their home, i.e. NHNN, Royal Free Hospital, North Middlesex Hospital, Barnet Hospital.
  • If the patient lives outside the North Central London area, they will be transferred to one of the 24 stroke units in London.
  • Alternatively if well enough, patients can be discharged and go home (about 40% of patients currently).
  • Patients who are brought in on the stroke pathway, who are subsequently found not to have had a stroke will be transferred to an appropriate local service or discharged home with recommendations to the GP for follow-up.

How does the HASU affect our existing stroke service?

We now see about 200 patients each month, about 100 of these are strokes and expect to treat over 1200 additional stroke patients per year.

Significant investment in staffing and funds to support and maintain the rigorous standards required for all HASUs

Pathways for accessing expert opinions such as neurosurgery and vascular surgery are more robust, and some patients have had surgery within 24 hours of arrival on the HASU.

Who manages the HASU?

Dr Rob Simister is the Clinical Lead of the UCH Comprehensive Service. The Divisional Senior Nurse is Liz Davies and the Operational Manager is Camelia Melody.

Within the HASU itself Simone Browning is the unit sister and Dr Rob Simister the unit’s consultant lead. The HASU is part of the Queen Square Division managed by Ian Haig, Divisional Manager, and Professor John Duncan, Divisional Clinical Director.

How does the HASU affect UCH?

  • Recognition and accreditation as a HASU for the re-designated stroke services in London
  • The UCLH HASU is the only one in the NCL sector
  • The HASU brings together expertise from UCLP partners
  • Sector-wide rotas for medical staff cited as exemplar
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