NHS AI framework offers decision support for stroke diagnosis

NHS Shared Business Services (NHS SBS) has introduced a framework to provide NHS organisations with access to artificial intelligence (AI) for supporting patients who have suffered a stroke.

The Provision of AI software in neuroscience for stroke decision making support procurement framework agreement aims to provide the NHS with a way to access image analysis technology for the detection of ischaemic or haemorrhagic strokes.

Developed with expert contributions from NHS England and NHS Improvement (NHSEI), clinical leads from the 20 Integrated Stroke Delivery Networks across England and the Academic Health Science Network, with further input from NHSX and the Care Quality Commission, the framework aims to offer a way for NHS organisations to access innovative technology startups. NHS SBS said the framework removes barriers and de-risks procurements of the products developed by these and other technology businesses. 

AI algorithms can be used to supplement the clinical decision-making process, providing real-time interpretation of imaging to augment the review, diagnosis and delivery of time-dependent treatments for the 100,000 people a year affected by stroke.

The NHS Long Term Plan sets out its objectives to improve services and outcomes for stroke patients, including attaining a tenfold increase in the proportion of patients who receive a thrombectomy after a stroke by 2022. The milestones for stroke care contain the scaling of technology to drive the expansion of life-changing treatments, including the use of AI interpretation of CT and MRI scans to support clinical decisions regarding suitability for thrombolysis and thrombectomy.

According to NHS SBS, AI can reduce the decision-making time for both thrombolysis and thrombectomy, increasing the numbers of patients eligible for both interventions and improving the likely benefit of treatment. It can provide interpretation of imaging within seconds, as opposed to up to 30 minutes when manual review of the images is undertaken remotely by a reporting doctor.

The use of AI software is also an integral part of the National Optimal Stroke Imaging Pathway (NOSIP). David Hargroves, Getting it Right First Time (GIRFT) clinical lead for stroke and national specialty advisor for stroke medicine at NHSEI, said: “Rapid brain imaging and its interpretation is arguably one of the most important steps in the care of patients with stroke-like symptoms.”

When a stroke is suspected, imaging acquisition of brain and vessel in the initial assessment is a top priority. “Adherence to the NOSIP, incorporating AI decision support software, is likely to improve access to disability-saving interventions to thousands of patients,” said Hargroves.

AI is considered to be of significant benefit in improving access to both thrombolytic therapy and mechanical thrombectomy in England. Darrien Bold, national digital and AI lead for stroke at NHSEI, said: “We are already seeing the impact AI decision-support software is having on stroke pathways across the country, and the introduction of this framework will drive forward further progress in delivering best-practice care where rapid assessment and treatment are of the essence. 

“Over the past 18 months, the heath and care system has been compelled to look to new technologies to continue providing frontline care, and the stroke community has embraced new ways of working in times of unprecedented pressure. This framework agreement will be of great benefit as we implement the NOSIP – driving better outcomes, better patient experience and better patient safety, using new technology quickly, safely and innovatively.”

Adam Nickerson, NHS SBS senior category manager for digital and IT, said: “By identifying areas in which technology can be used to help speed up patient pathways, clinicians have more time for providing personalised care and patient waiting lists – exacerbated by the pandemic – are reduced.

“The suppliers on our framework agreement are working right at the cutting edge of healthcare. Their work is already improving and saving the lives of patients who – as a result of this digital healthcare technology – are given access to the right treatment more quickly.”