NICE guidelines on stroke will save an estimated £2 million

Statement outlines savings of implementing NICE guidelines on stroke care

Published on 22nd July 2019

Implementing NICE guidelines on stroke care will cost around £18.6 million in 2023/24, although this will be offset by NHS and social care cost savings of around £16.2 million.

NICE, NHS England and NHS Improvement, NHS Clinical Commissioners, and Health Education England have produced an NHS workforce and resource impact statement highlighting the work being done by national partners to integrate changes recommended by NICE in its updated stroke guideline into routine NHS patient care.

The statement has been published to help commissioners and trusts understand the potential impact on the NHS workforce and resources of implementing specific NICE guidelines.

It highlights that stroke affects around 230 people per 100,000 each year, with over 80,000 people going to hospital every year in England. Stroke is the single biggest cause of disability in adults, and it is estimated that it costs the NHS £2.98 billion per year. A further £4.55 billion per year is estimated to be spent on social care for people who have had a stroke.

NICE recommends increasing the provision of thrombectomy, a procedure to remove the blood clot causing the stroke. The estimated cost of this is around £3.7 million in the first year, rising to £18.5 million in year 5. However, it is likely that these will be offset by cost savings for NHS and social care services of around £15.4 million in year 5 as a result of shorter hospital stays and reductions in future NHS care and social care costs.

In addition, the potential increased costs of additional MRI requests for patients suspected of having a ‘mini-stroke’ – a transient ischaemic attack (TIA) - will be offset by savings gained through no longer routinely offering CT brain scanning to everyone with a suspected TIA. It is estimated that the net impact of these recommendations is a cost saving of around £800,000 in year 5.

"Overall, implementation of the guideline in England will cost around £18.6 million in 2023/24, although this will be offset by NHS and social care cost savings of around £16.2 million," said the statement.

It also highlights that NHS England is supporting specialised commissioning for the implementation of a thrombectomy service specification across the country to ensure the provision of the most effective, up-to-date treatments which will improve patient care. Health Education England will work with the medical Royal Colleges and others to develop new training programmes for hospital consultants to offer mechanical thrombectomy.

The new Stroke Delivery Board, introduced as part of the NHS Long Term Plan, includes a focus on increasing rates of thrombectomy, as well as improving the delivery of hyper-acute stroke pathways. Delivery and performance will be monitored and supported regionally by NHSE and the Getting it Right First Time (GIRFT) Stroke Programme.

The statement was developed by a guideline resource and implementation (GRIP) panel which included members from NICE, Health Education England, NHS Clinical Commissioners, and NHS England and NHS Improvement. The GRIP panel has been set up to focus on NICE guidelines that are most likely to have a substantial resource impact on the NHS.

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