More improvement needed in stroke patient care

Many stroke patients are still missing out on vital fundamental treatment, a report has found.

The National Sentinel Audit for Stroke, the largest ever examination into the care of stroke patients in England, Wales and Northern Ireland highlighted a number of areas where stroke treatment could be improved.

The audit found that there was a lack of specialist stroke units, with 54% of patients not receiving care in such a unit and 60% not spending the majority of their hospital stay in one.

There were also delays found in patients receiving potentially life-saving checks. 53% of suspected stroke patients involved in the audit waited over 48 hours to receive a brain scan.

The audit said that aspirin was widely prescribed to prevent a stroke or further strokes in patients most at risk, because it was effective at reducing mortality rates and disability. However, findings showed that a third of patients eligible to take the medication did not start the treatment until 48 hours after their stroke.

The audit, which was carried out on behalf of the Royal College of Physicians, said that the delays could be explained by stroke not being considered a medical emergency, although brain scanning would help to highlight people who would benefit most from treatment.

The report also found that a third of patients were not having their ability to swallow assessed, despite a third of stroke patients being affected by swallowing problems, which could increase the risk of choking and coughing and may also lead to chest infections and pneumonia. The audit said that this was an issue of "grave concern".

The audit said that some hospitals were delivering "exceptionally high quality care", but that standards needed to be risen to acceptable levels in all hospitals.

Jon Barrick, Chief Executive of the Stroke Association, said that standards in stroke care have "vastly improved" over the past twenty years. However, he said: "It is extremely disappointing to see patients across the country are still waiting to get the essential care that they should receive according to government-set standards. Patients are still waiting to be promptly diagnosed and to have immediate access to specialist staff. We are still waiting for stroke to be made the medical priority that it should be. This is scandalous when you consider that it is the third biggest killer and the biggest cause of long-term disability."

Each year 130,000 people in England and Wales suffer a stroke, according to the Stroke Association. A third of these people are likely to die within the first ten days, a third are likely to make a recovery within a month and a third are likely to be left disabled and requiring rehabilitation. Stroke Association figures also indicate that a quarter of a million people suffer from long-term disability as a result of having a stroke.

(KMcA/SP)