Embracing innovation to drive positive change to clinical practice in stroke care

The introduction of new technologies into clinical practice is essential for addressing unmet medical needs and improving patient outcomes. Clinicians bear the responsibility of identifying these gaps and ensuring that proposed solutions are both safe and effective. The NHS prioritises the adoption of innovations that either offer superior alternatives to existing treatments or cater to patient populations for whom current options are inadequate.1 One such example is the Royal Stoke University Hospital’s successful integration of artificial intelligence (AI) decision-support tools to enhance stroke care. By significantly reducing the time required to process and interpret brain scans, AI enables clinicians to make faster treatment decisions, thereby improving access to life-saving interventions, such as thrombolysis and mechanical thrombectomy. This case underscores the critical role of leadership in implementing change within clinical practice.A particularly impactful instance of innovation addressing an unmet need is the adoption of a neuromuscular electrostimulation (NMES) device to prevent venous thromboembolism (VTE) in immobile stroke patients. VTE is a significant risk for individuals with reduced mobility, and existing preventive measures, such as intermittent pneumatic compression (IPC) sleeves, are not viable for ∼30% of acute stroke patients due to discomfort or contraindications.2 To address this gap, the clinical lead and his team conducted a real-world 1,000-patient observational pilot study to evaluate the efficacy of a NMES technology. The NMES device stimulates nerves in the leg to activate calf and foot muscle pumps, increasing venous blood flow in the deep veins, significantly reducing VTE incidence, with no cases reported in the NMES-treated group.The successful adoption of this technology was facilitated through leadership and a structured, multidisciplinary approach involving key stakeholders. Governance bodies, including Directorate, Divisional, and Trust governance, ensured regulatory compliance. The hospital pharmacy department incorporated the NMES device into treatment protocols, while the stroke unit’s multidisciplinary team collaborated on study design, patient recruitment and data collection. Training programs were implemented to familiarise staff with the technology, and a database was established to monitor patient outcomes and assess long-term efficacy. The observed success of the NMES intervention has prompted its expansion to additional stroke centres across the UK and internationally.The Royal Stoke Hospital’s experience highlights several key factors in the successful introduction of clinical innovations: identifying unmet clinical needs, rigorously evaluating new technologies, fostering multidisciplinary collaboration and systematically integrating novel solutions into routine practice. This case serves as a model for broader NHS adoption of transformative medical technologies, demonstrating how leadership and evidence-based practice can drive meaningful improvements in patient care and healthcare system savings. The dissemination of successful interventions across healthcare settings ensures that innovative solutions continue to address critical gaps, ultimately enhancing health outcomes on a larger scale. 1. The Innovation Ecosystem Programme – how the UK can lead the way globally in health gains and life sciences powered growth. www.england.nhs.uk/publication/the-innovation-ecosystem-programme/. [Accessed 7 June 2025]. 2. CLOTS (Clots in Legs Or sTockings after Stroke) Trials Collaboration; Dennis M, Sandercock P et al. Effectiveness of intermittent pneumatic compression in reduction of risk of deep vein thrombosis in patients who have had a stroke (CLOTS 3): a multicentre randomised controlled trial. Lancet 2013;382:516–24.

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