Introduction In 2023 the neurovascular advanced clinical practice (ACP) team expanded to support all patients who had bleed from a neurovascular pathology. To better understand this population and to tailor service development, a service evaluation was completed.

Aim of Study To describe the population supported by the ACP service, understand patient pathways, and identify common challenges experiences by patients.

Methods Routinely collected patient data was analysed for patients seen between March 2023 and February 2024, including demographics, admission information, and physical and mental well-being outcome measures at discharge and follow-up.

Results 229 patients were included. The majority had subarachnoid haemorrhage (76%), with most others having arteriovenous malformations (16%), arteriovenous fistulas (3%) and cavernomas (2%). Mean age was 56 and around half (53%) were female. Half required ICU admission (50%), and 51% had neurological deficits. Median length of stay was 12.5 days (2.1-128 days). Most patients were discharged home (68%), but 24% required inpatient rehabilitation. At discharge 66% rated their physical health as poor or fair and 60% rated their mental health as poor or fair.

At a 6-week follow-up, 32% rated their physical health as poor or fair and 42% reported their mental health as poor or fair. Anxiety and/or depression was reported by 76%. Moderate to very severe fatigue was reported by 52% and 63% had ongoing pain.

Conclusion Neurovascular patients had variable admission and rehabilitation pathways. Physical and mental health concerns were prevalent and persistent at 6-week follow-up. The ACP team supports patients with these challenges along the clinical pathway.

Disclosure of Interest no.