1. Northern England Strategic Clinical Network Conference 15 th May 2015 Vascular Update Professor Gerard Stansby Newcastle upon Tyne gerard.stansby@nuth.nhs.uk

2. Top 3 achievements we want to celebrate and share Aortic aneurysm screening established in the North-East for all 65 year old men Improved delivery of carotid surgery to prevent stroke Agreed protocols for assessing and treating PAD – your legs are killing you!! Aortic aneurysm screening established in the North-East for all 65 year old men Improved delivery of carotid surgery to prevent stroke Agreed protocols for assessing and treating PAD – your legs are killing you!!

3. Top 3 priorities in our region 2015-17 Priorities Vascular Surgery Services Review – fewer better central units with hub and spoke to other hospitals Reduction of amputation rates including in diabetics – NE has highest rates in the NHS Improved timelines for delivery of carotid interventions after TIA and stroke Vascular Surgery Services Review – fewer better central units with hub and spoke to other hospitals Reduction of amputation rates including in diabetics – NE has highest rates in the NHS Improved timelines for delivery of carotid interventions after TIA and stroke Expected outcome Continued provision of world quality vascular surgical services in the NE including aortic surgery Huge cost savings and obvious benefits for patients and carers Stroke prevention Continued provision of world quality vascular surgical services in the NE including aortic surgery Huge cost savings and obvious benefits for patients and carers Stroke prevention

4. What we need and what we fear What we need to help us achieve our top 3 regional priorities Signup from Trusts, Clinicians & Commissioners and public to agree the best configuration for vascular services. MDT working with diabetes, podiatry and others including GP and between sites needed. Agreed pathways for referral, transfer and intervention including 7 day working and imaging Signup from Trusts, Clinicians & Commissioners and public to agree the best configuration for vascular services. MDT working with diabetes, podiatry and others including GP and between sites needed. Agreed pathways for referral, transfer and intervention including 7 day working and imaging What we fear might stop this happening Market forces in the NHS preventing reorganisation and associated investment. Inertia and lack of prioritisation of diabetic foot and PAD in commissioning priorities Competition with other conditions and specialities for beds and theatre time Market forces in the NHS preventing reorganisation and associated investment. Inertia and lack of prioritisation of diabetic foot and PAD in commissioning priorities Competition with other conditions and specialities for beds and theatre time