AROUND a third of all stroke patients in Gwent will spend less time in hospital and receive their rehab at home as a major revamp of services gathers pace.

Emergency stroke care - focusing on the first three days after a stroke - is being centralised at a new hyper-acute unit at the Royal Gwent Hospital.

This will be backed up by 'step-down' acute stroke care (four-seven days post-stroke), provided at the Royal Gwent and Nevill Hall Hospitals, and Ysbyty Ystrad Fawr in Ystrad Mynach.

But inpatient stroke rehabilitation will be provided in future at just three sites - Nevill Hall, Ysbyty Ystrad Fawr, and St. Woolos Hospital in Newport - instead of seven.

And filling that inpatient rehab gap for less serious cases will be a community neuro-rehabilitation service, which Aneurin Bevan University Health Board believes will bring a much improved quality of aftercare for stroke patients.

The latest stage of the redesign of stroke services will see the closure of two inpatient rehab wards, at County Hospital in Griffithstown, and Ysbyty Aneurin Bevan in Ebbw Vale.

The health board stresses that the changes are based on clinical evidence, that patients who have experienced a mild to moderate stroke show much better improvement when they have their rehabilitation at home, and 30 per cent more will receive this through the revamped service.

"The changes will enable more patients to return home more quickly and be supported through their rehabilitation in their own home," said a health board spokesman.

"These changes have been supported by Aneurin Bevan Community Health Council."

At the emergency end of the stroke care spectrum, the aim of centralisation through one hyper-acute stroke unit is to create a centre of excellence, while the reduction in inpatient rehab wards will also concentrate expertise.

Around 900 people a year are admitted to hospital in Gwent having suffered a stroke. A further 700 require hospital treatment for a transient ischaemic attack (TIA), regarded as a warning sign of the possibility of full-blown stroke.

The service changes are driven by a need to make the health board better able to achieve standards set by the Sentinel Stroke National Audit Programme (SSNAP).

This measures stroke services in England and Wales against a range of criteria, including organisation, specialist roles, staffing, communication and services available to patients after discharge from hospital.

Last year, SSNAP results revealed that while stroke services across Wales have generally improved, they largely scored lower than their English counterparts, and there remains much room for improvement.

Reorganisation will involve changes to working practices for staff and they have been invited to comment on the proposals.

*Four stroke rehab beds will close at County Hospital, along with eight at Ysbyty Aneurin Bevan, but the health board intends that these remain available for use as additional capacity at times of high demand.