Stroke Care In England - A Postcode Lottery

Main Category: Stroke
Article Date: 10 Dec 2007 - 4:00 PDT

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On the morning that Alan Johnson MP Secretary of State for Health announces the Governments first ever National Stroke Strategy, research shows the current life threatening state of stroke care in England.

Joe Korner, Director of Communications for the Stroke Association explains: 'Stroke is the UK's third biggest killer and if it doesn't kill it can leave patients paralysed, incontinent and or unable to talk. Yet, despite clear clinical evidence that access to immediate brain scanning and admission directly to a stroke unit saves lives and reduces disability - current access to these life saving facilities is down to luck and postcode.'

Only 42 per cent of patients in England receive a brain scan to confirm their diagnosis within 24 hours. London offers the best service with 58 per cent of patients receiving a brain scan in this time frame. Just 37 per cent of those living in the East of England received a scan in 24 hours. Furthermore the inability of hospitals to be able to provide brain scans outside of normal working hours puts lives at risk. Stroke patients in the East Midlands are most likely to be scanned within 24 hours at the weekend, but only 6 per cent of those admitted at a weekend in the South East receive scans.

Despite strong clinical evidence that being treated on a stroke unit improves a patient's chance of survival by a quarter and increases chances of independence by 18 per cent only 62 per cent are admitted to a stroke unit.

And, even for those who are lucky enough to be treated on a stroke unit many find that these units are simply a sign on the door and are not adequately staffed or resourced. Seventy two percent of patients in the North East are treated on a stroke unit, ranking best in the country compared to just 51 per cent in the East Midlands, ranking bottom.

However today, the Government promises hope to the 130,000 people in England who have a stroke each year with the launch of the National Stroke Strategy.

Joe Korner continues: 'For too long stroke has been a low priority for Government and health providers. Current stroke care is a matter of luck and postcode and we are looking for the National Stroke Strategy to change this

'The strategy must ensure that stroke and TIA are always treated as emergencies. Equally every stroke survivor must have access to an adequately staffed stroke unit to improve chances of survival and reduce disability.'

However the charity stresses with the public's lack of awareness on stroke all the work that has gone into the strategy could be in vain.

Korner concludes: 'The public are still unaware of the symptoms of stroke and TIA and its subsequent devastating impact - just 55 per cent of the population know what a stroke is and only 40 per cent know what the symptoms are and this is where the problem really starts. If the Government are serious about reducing stroke then there must be funding into a public awareness campaign on stroke and TIA, the symptoms and prevention.'

Notes:

1. Data that illustrates the postcode lottery of stroke care is taken from the 2006 National Sentinel Audit for Stroke:

Brain scan received within 24 hours

Strategic Health Authority - Percentage
London 58%
South Central 44%
South East Coast 43%
Yorkshire and Humber 42%
North West 41%
East Midlands 40%
North East 40%
South West 39%
West Midlands 39%
East of England 37%

Percentage of stroke patients who received a brain scan at the weekend

Strategic Health Authority - Percentage
East Midlands 36%
London 30%
East of England 26%
South West 24%
North East 21%
Yorkshire and Humber 18%
West Midlands 14%
North West 12%
South Central 8%
South East 6%

Number of patients treated in a Stroke Unit

Strategic Health Authority - Percentage
North East 72%
West Midlands 68%
London 67%
South West 64%
North West 64%
South Central 64%
Yorkshire and Humber 63%
South East Coast 63%
East of England 60%
East Midlands 51%

Care in a stroke unit

Even in areas with good overall care, the level of stroke care is very dependent on the hospital you are admitted to. Overall only 50 per cent of hospitals have acute stroke units with all six features.

East Midlands -Only two sites report 100 per cent features.

East of England - Two sites have 100 per cent

London - Seven sites report 100 per cent of the features.

North East - Five sites have 100 per cent of the features.

North West - Eight sites have 100 per cent of features.

South Central - Two sites have 100 per cent of features.

South East Coast - Two sites have 100 per cent of features.

South West- Nine Hospitals have no features with only 3 with 100 per cent of the features.

West Midlands - Only one reports all six features

Yorkshire and Humber - Two sites have 100 per cent of features.

2. The Stroke Association is the only UK charity solely concerned with combating stroke in people of all ages. The charity funds research into prevention, treatment, better methods of rehabilitation and helps stroke patients and their families directly though its community services which include communications support, family and carer support, information services, welfare grants, publications and leaflets. The Stroke Association also campaigns, educates and informs to increase knowledge of stroke at all levels of society acting as a voice for everyone affected by stroke.

3. A stroke is a brain attack which causes brain damage. A stroke can be diagnosed by using FAST - Facial weakness, Arm weakness, Speech problems, Test all three. If any of these symptoms are present call an ambulance straight away.

4. The Stroke Helpline provides information on stroke to the general public and is open between 9am - 5pm Monday to Friday on 0845 3033 100.

Stroke Association