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Wessex Global Stroke Partnerships

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CSC fellows spend 2 weeks with the Stroke MDT at University Hospital Dorset

June 5, 2025 Louise Johnson

WGSP team barbeque

The CSC fellowship programme for Dr Valentine Akwulpwa (Ghana) and Charge Nurse Yahya Njie (The Gambia) has continued with a busy two-week placement at University Hospitals Dorset (UHD, Bournemouth and Poole). Here they summarise the wide range of topics covered since their arrival in the UK, with reflections on potential benefits for stroke care in low- and middle-income countries (LMICs):

Clinical Skills, Knowledge, and Experience:

  • Hyperacute stroke care including assessment for time critical interventions: thrombolysis and thrombectomy. Emphasis on rapid imaging to treatment pathways

  • Neurocritical monitoring (e.g. managing raised intracranial pressure, dysautonomia) and post-procedural protocols to reduce haemorrhagic transformation risk

  • Advanced rehabilitation techniques including hands on experience of ‘Walkerbot’ gait-retraining for patients with severe motor deficits, integrating AI-driven adaptive support into standard stroke care practices

  • MDT-led early mobilization protocols <24 hours post-stroke, reducing pneumonia risk and length of stay

  • Complex case management, high-risk TIAs, stroke mimics e.g. seizures, functional disorders, and young stroke clinics addressing rare etiologies

  • Dysphagia screening with standardized bedside water tests and videofluoroscopy, minimizing aspiration pneumonia

Leadership:

  • Service consolidation, and culture following a strategic merger of acute / rehab units, enhancing staff flexibility and reducing mid-pathway transfers

  • Daily safety huddles, incident reporting, resource allocation, and real-time problem-solving

  • Staff empowerment and fostering psychological safety within the team; cross-discipline training initiatives e.g. nurses trained in NIHSS scoring; therapists empowered for thrombolysis screening

  • Succession planning: deputy leads shadowing consultants ensuring service continuity for the future

  • Resource optimization: 43-bed unit with dynamic zoning (hyperacute / rehab), maximizing capacity without new infrastructure

Partnership:

  • Regional networks including Hub-And-Spoke Model of regional care provision. Witnessed coordinated transfers from Winchester to Southampton for thrombectomy with shared telemedicine consultation

  • Community integration: witnessed collaboration between the UHD stroke service and Integrated Community Stroke Service (ICSS) for seamless home-based rehab, reducing readmissions by 18%

Global health synergies:

  • Contextual adaptation: UHD’s ‘low-tech, high-skill’ approach e.g. manual handling techniques which are directly applicable to LMIC resource constraints

  • Knowledge exchange: we shared WGSP's 8 core skills modules (e.g. swallowing, positioning) for potential integration into UHD training programmes for staff and families alike

  • Frugal innovation: UHD use of low-cost gait aids (e.g. bamboo parallel bars) aligns with WGSP's philosophy of sustainability

  • Data-driven care: the national UK electronic stroke registry (SSNAP: Sentinel Stroke National Audit Programme) tracking outcomes such as door-to-needle time, demonstrating potential for improvements in LMIC services and care provision through audit

Appreciation to all the WGSP UK team:

  • Hospitality: Thank you for the warm reception, accommodation support, and inclusive participation in MDT meetings, ward rounds, and community visits

  • Mentorship: Special gratitude to all the consultants, rehab therapists, and nurse leaders for their patience in skill demonstrations and case discussions

  • Collaborative spirit: The willingness to share protocols, governance frameworks, and failures openly has equipped me (Dr Val) to advance stroke care at Tamale Teaching Hospital

  • This attachment exemplifies the WGSP's mission of sustainable change through equitable partnership

Commonwealth Scholarship Commission Fellows placement starts at Hampshire Hospitals →

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