Delays in Stroke Diagnosis Causing Avoidable Deaths

Delays in diagnosis and treatment of stroke are causing unnecessary deaths and disability, according to a report from The Stroke Association, ‘What’s the Emergency?’ published today (6 October).

The results of a recent MORI poll, commissioned by The Stroke Association, also shows worrying low levels of public understanding and knowledge about stroke. 51% could not identify what a stroke is, 41% did not think death rates could be reduced through emergency treatment and 48% did not think the incidence of disability could be reduced through emergency treatment.

The Stroke Association is calling for strokes to be treated as a medical emergency to improve the prospects for everyone affected by this potentially devastating condition. Urgent change is needed in two areas: first the general public needs to be able to recognise the symptoms of stroke and to dial 999 if they suspect a stroke; and second the health service needs to be organised so that someone with a suspected stroke gets a brain scan and diagnosis within three hours.

It is vital that the Government supports these changes, making rapid treatment of stroke a priority and also with a sustained public awareness campaign. Stroke is a leading cause of disability and the third biggest killer in the UK. Each year over 130,000 people in England and Wales have a stroke. There is strong evidence to suggest that the prevalence of stroke will increase as the number of older people within our population is predicted to increase dramatically over the next 20 years, making urgent action by the Government even more crucial.

Jon Barrick, Chief Executive at The Stroke Association says “Stroke clinicians talk about a “rule of thirds” with stroke - that a third are likely to die, a third become permanently disabled and a third recover. We believe that “rule of thirds” can and should, urgently, be broken. If the time between the onset of a stroke and diagnosis was no more than three hours, thousands of people could have a much better chance of avoiding death or becoming disabled. All too often, there are severe delays. We want to alert the public to the need to act FAST on stroke, and we need to see dramatic improvements in emergency brain scanning. It is a scandal that more than half of stroke patients wait more than 48 hours for a brain scan.“

Maggie Huggett, aged 61, had a very bad headache for several days, which painkillers did not seem to relieve. She then collapsed at work and was taken to hospital in an ambulance. She was in hospital for two weeks before any tests started to happen and this was only because her husband became angry and pushed for the doctors to do more as Maggie was finding it difficult to eat or drink because she could not swallow. This was the first of eight strokes that Maggie has had since 1996. She was paralysed down her right side and now has epilepsy and speech problems.

The lack of brain scanning services, including staff, is one of the main problems causing severe delays in diagnosis. Less than half of all patients in England, Wales and Northern Ireland have a brain scan within 48 hours of having a stroke according to the Royal College of Physicians Sentinel Audit of stroke services (2004). It is vital that every hospital has access to emergency scanning facilities and assessments 24 hours a day, 7 days a week to meet the target of three hours from onset to diagnosis.

The lack of properly equipped, staffed and organised acute stroke units is also a barrier to patients receiving the best care. Too few patients are treated in them and even when they are, they frequently do not spend sufficient time on them. The Stroke Association is calling for 100% of stroke patients to have access to an acute stroke unit and for 100% of stroke units to have the full range of specialist facilities required.

To raise public and professional awareness of stroke symptoms, The Stroke Association is promoting the Face, Arms and Speech Test developed by Professor Gary Ford with research funding from the charity. Gary Ford’s research has shown that FAST is an accurate tool for paramedics to identify suspected stroke. Act FAST materials will be widely distributed explaining how the public can use FAST to identify a suspected stroke, and urging them to dial 999 if they suspect a stroke.

FAST stands for
Facial Weakness -can the person smile? Has their mouth drooped?
Arm Weakness - can the person raise both arms?
Speech Problems - can the person speak clearly and understand what you are saying?
Test all three symptoms.

The Stroke Association urges health experts and professionals to sign up to our consensus statement on emergency stroke care and asks the government to ensure that the urgent improvements required are not achieved at the expense of other vital areas of stroke care.

The Association has created a variety of resources on how to Act FAST on stroke including a wallet sized card for use as a reference aid, Act FAST wristbands and posters available to the public from The Stroke Association website or from Sonia Bryant on 01604 623938.

ENDS
For further information please contact the Media Team at The Stroke Association on 020 7566 1500 or at press@stroke.org.uk

Notes to editor

1. The Stroke Association report " What's The Emergency?" is available free to journalists from the Media Team on 020 7566 1500.

2. The public survey of stroke awareness was carried out by MORI in England, Wales and Scotland during August 2005.

3. The Stroke Association is supported in this campaign to get stroke recognised as a medical emergency by health professionals including the Ambulance Association.

4. The Stroke Association is the only charity in England and Wales solely concerned with combating stroke in people of all ages. It funds research into prevention, treatment and better methods of rehabilitation and helps stroke patients and their families directly through its community services.

5. A stroke happens when the blood supply to the brain is disrupted. Most strokes occur when a blood clot blocks the flow of blood to the brain. Some strokes are caused by bleeding in or around the brain from a burst blood vessel.

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