HSJ Value Awards 2018: Improving the Value of Surgical Services

Winner

University Hospitals of North Midlands Trust: Savings to the Health Economy – Introduction of Mechanical Thrombectomy, a new minimally invasive surgical technique

University Hospitals of the North Midlands Trust has introduced a new mechanical clot extracting interventional technique for patients with strokes. The previously gold standard treatment – thrombolysis – was only effective in 15-20 per cent of patients with large vessel occlusive strokes, and patients with severe strokes had an average stay of 90 days in a stroke unit, costing over £31,000 per patient.

Thrombectomy could be done in a longer timescale and has been shown to improve outcomes for many patients. This project was implemented with input from interventional neuroradiology, stroke, anaesthetics, accident and emergency and ITU teams and led to a 24/7 service being supported by commissioners when early results were presented to them.

This new technique has reduced the mortality rate from 40 per cent to 17 per cent among the 350 patients treated. It has also reduced the average hospital stay from 90 days to 12 days, and 90 per cent of patients are now discharged home (previously 60 per cent) rather than to a nursing home due to significant impairment.

The National Institute for Health and Care Excellence has estimated that trusts could achieve savings of £2.4 million annually, due to shortened hospital stays and savings from ongoing social care costs. The cost saving model published by NICE is being used by other NHS organisations to help develop this service, and University Hospitals of North Midlands Trust has also facilitated visits from other trusts to aid development.

Read a detailed case study about this project at HSJ Solutions