"Care for people who have had a stroke
has significantly improved since we reported in 2005. The
publication and early implementation of the stroke strategy have
begun to make a real difference and have helped to put in place the
right mechanisms to bring about these improvements. There is still
work to be done though: the poorer performers must be dragged up to
the same standard as the best, so that the gains that have been
made are sustained and value for money improved further. The
Department should focus on ensuring that health, social care and
employment services are working together much more
effectively."
Amyas Morse, Head of the National Audit Office, 3 February
2010
The Department of Health's strategy for stroke
care has increased the priority and awareness of the condition and
started to improve patients' care and outcomes, concludes a report
by the National Audit Office published today. Actions taken since
2006 have improved the value for money of stroke care; but
improvements have not been universal and improvements in follow-up
care have not matched those of acute care services.
The National Stroke Strategy is a
comprehensive response to the concerns raised by the NAO in its
2005 report on stroke. The strategy has been underpinned by strong
national leadership and performance indicators as well as £59
million of central funding over the first two years, £30 million of
which was allocated to local authorities specifically to provide
support services to stroke patients and their carers. With
this clear focus from Ministers and the Department, the NHS is now
starting to deliver better care from stroke services, and outcomes
for patients are also improving. The NAO estimates that stroke
patients' chances of dying within ten years have reduced from 71 to
67 per cent since 2006.
Patients treated in a specialist stroke unit
are more likely to survive, have fewer complications and regain
their independence, and all relevant hospitals in England now have
such a unit, although the services provided and time spent in the
unit vary. Stroke patients should be immediately admitted to a
specialist stroke unit; however in 2008 only 17 per cent of stroke
patients reached the stroke unit within four hours of arrival at
hospital. Brain imaging is also very important for stroke patients
but many patients are not given a scan quickly enough and access at
weekends and evenings is significantly more limited.
There is better awareness of the symptoms of
stroke, and that it is a medical emergency, following the
Department's 'Stroke: Act FAST' advertising campaign, launched in
February 2009. The number of calls categorised as being a
suspected stroke during April to June 2009 increased by 54 per cent
in comparison with the same period in 2008.
However, health and social care services are
not working as well together as they could. A third of
patients are not getting a follow-up appointment within six weeks
and only a half of stroke survivors in the NAO's survey said that
they were given advice on further stroke prevention when leaving
hospital.
Publication details:
HC: 291, 2009-10
ISBN: 9780102963441