Stroke Referrals
About 1,000 patients with stroke and 1,300 referred with suspected stroke are admitted to hospital or seen in the TIA clinics at St John’s Hospital (SJH) and the Royal Infirmary of Edinburgh (RIE) each year.
Acute stroke services are provided at the RIE, the WGH and SJH.
Patients can refer themselves to accident & emergency (A&E) departments at the RIE or SJH, or be referred by GPs/ out of hours medical services. Patients are usually referred to the hospital serving their area for acute medical admissions:
- North Edinburgh patients to the WGH
- South Edinburgh patients to the RIE
- West Lothian patients to SJH
- some East Lothian patients are admitted to the Medicine for the Elderly Service at Roodlands Hospital
Stroke Unit Services
Each hospital provides similar stroke unit care. We aim to transfer all stroke patients to a specialist stroke unit as soon as possible after admission.
Admission
The three acute hospitals each have an integrated stroke unit (combination of acute and rehabilitation). There are 22 beds at SJH, 24 beds at WGH and 44 beds at RIE. The RIE admits the largest proportion of patients directly from its emergency department to the acute stroke unit.
When no stroke unit bed is available patients may be admitted to general medical or geriatric assessment wards. Patients remain in acute units for 2-3 weeks on average.
Rehabilitation
Most people are discharged home from hospital after a stroke but some will require the specialist services provided by NHS continuing care or a nursing home.
At all sites, the acute and rehabilitation units are integrated in the same ward. Patients who need prolonged rehabilitation are transferred to off-site specialist stroke rehabilitation unit at the Astley Ainslie.
Services for TIAs/ Mini Strokes – Outpatients
The SJH, RIE and WGH sites provide rapid access one-stop TIA/stroke clinics for all Lothian patients with transient ischaemic attacks (TIAs) – mini strokes – minor strokes and conditions which mimic these. Click here to see what happens at the TIA/stroke Clinic at the WGH
Some are referred on an emergency basis to A&E departments (RIE or SJH) or the Acute Receiving Unit at the WGH. Here patients are initially assessed, possibly stay overnight in an assessment area and then are referred to the RIE or SJH TIA/stroke Clinic. This referral ensures patients’ investigations are complete and that they receive best possible information on secondary prevention – to limit the re-occurrence of another TIA, stroke or possible heart disease.
Some patients are then referred to selected rehabilitation services as appropriate or managed by a community-based rehabilitation team, reviewed in geriatric day hospital or receive outpatient based therapy.
Information leaflets from Chest, Heart & Stroke Scotland are available at each clinic, and you can contact them for further advice on their hotline.
