NHS 'has more to do over stroke'

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Stroke services are improving, but there are still some gaps in care, an audit of hospitals in England, Wales and Northern Ireland has shown.

The Royal College of Physicians quizzed 224 hospitals about their services.

The study, funded by the Healthcare Commission watchdog, found improvements, particularly in provision of clot-busting thrombolytic drugs.

But it concluded that more should be done to ensure access to scans and make the most of specialist stroke beds.

Some 15% of these beds did not have stroke patients in them, which was described as a "nonsensical" situation and a waste of resources.

There is a powerful consensus for change and this audit demonstrates that we are gaining momentum Joe Korner, Stroke Association

The report also pointed out that while most hospitals had specialist stroke beds, just 16% of them were employing direct admission to them as they were expected to do.

It also raised concerns about access to CT and MRI scanning, which is essential for the diagnosis of stokes and, in particular, mini-strokes known as transient ischaemic attacks which can often get missed.

Guidelines say scans should be done within 24 hours and while all hospitals have CT scans and most MRI machines, access at weekends and nights was patchy because trusts struggled to have enough staff to operate them out-of-hours.

Concern was also raised about access to stroke rehabilitation units.

Nearly all units had a policy of not admitting people who were deemed not being able to benefit significantly, even though doctors believe all patients can be helped to some extent.

But overall the report praised the way stroke units were now set up.

More than 90% of hospitals had stroke units - up from three quarters six years ago - while a similar number had doctors with specialist knowledge of the condition.

And the availability of thrombolytic drugs had increased four-fold since the last audit was carried out two years ago.

Deaths

In total, a third of hospitals were actively using the clot-busting treatment when necessary.

The news comes as the government is rolling out its stroke strategy, which has promised an extra £105m investment over the next three years to improve services.

Strokes are the third biggest killer - behind cancer and heart disease - responsible for 50,000 deaths a year.

Dr Tony Rudd, of the Royal College of Physicians, said he was "delighted" with the results.

But added: "Hopefully these results will not induce a sense of complacency because we still have a long way to go."

Health minister Ann Keen agreed there had been "major improvements" in recent years.

She also pointed out that many hospitals were beginning to work together in networks, while local authorities were putting programmes in place to support the long-term needs of stroke survivors.

Joe Korner, of the Stroke Association, said: "There is a powerful consensus for change and this audit demonstrates that we are gaining momentum. But we have a long way to go."