National Audit Office and Public Accounts Committee follow up reports: Progress in improving stroke care

On 3 February 2010 the National Audit Office (NAO is the organisation responsible for scrutinising public spending) published its evaluation of how stroke care in England has changed over the last four years.

The report, which can be viewed in full, follows up the groundbreaking 2005 NAO study that exposed the lack of priority that was being given to improving stroke care and the needless death and disability this was causing.

The NAO conclude that the actions taken by the Department of Health have improved value-for-money in stroke care and resulted in a reduction in the chances of dying after a stroke.

However, the NAO also highlight areas of remaining serious concern. In particular it shows that the welcome improvements in emergency and hospital care are not yet being matched in post-hospital and longer term support for stroke survivors.

The NAO also recommend that the NHS and Local Authorities must plan how they will continue improvements in stroke care after the end of additional funding for implementation of the National Stroke Strategy in 2010-11 and in light of the current financial pressures facing the NHS and Local Authorities.

The House of Commons Public Accounts Committee made up of MPs from each of the main political parties held an evidence session on the reports findings on 24 February 2010.

Senior NHS figures involved in stroke care, including the NHS Chief Executive Sir David Nicholson and Professor  Roger Boyle, National Clinical Director for Heart Disease and Stroke, gave evidence on the progress that has been made on improving stroke care in England.

Members of the Committee questioned the witnesses on a range of issues around stroke care including concerns raised by The Stroke Association on the time taken for stroke patients to get onto a stroke unit after arrival at hospital and the long term future of community stroke support services.

You can read a transcript of this session here or watch a recording of the hearing here.

On 30 March 2010 the Public Accounts Committee published its report on improving stroke care based on the findings of the NAO and the evidence provided to the Committee at its recent hearing.

The Committee welcomed the “demonstrable improvements” in stroke care that had been made over the past four years and highlighted in particular the increased priority given to the speed of emergency hospital response to stroke and the efforts made through the “excellent” Act FAST campaign to raise professional and public awareness of stroke symptoms.

However the report also highlighted concerns about the variability of improvements around the country

The timely scanning of suspected stroke patients and rapid access to stroke units were focused on as two particular areas in need of further improvement.

The Committee also echoed The Stroke Association’s concerns about post hospital and longer term support for stroke survivors.

The report agreed with the NAO that the improvements in hospital care are not yet matched by progress in delivering more effective support once people are back in the community.

The Committee also recognised that next years end to additional funding for implementation of the National Stroke Strategy posses a risk to the current improved level of post hospital support. In response to this the Committee recommended that the Department of Health report back to them on progress made in post hospital and long term support within 12 months.

You can view the full report on the Public Accounts Committee website.

The Stroke Association has produced a briefing on the report, which highlights the main areas of concern and our thoughts on its findings.

Download: Public Affairs Briefing - NAO Stroke Care Progress 2010 (54 kb) [pdf] 

The Stroke Association has also drafted an official response (20 kb) [pdf].