Why Are We Waiting?

The Stroke Association is issuing a wake up call to the NHS, saying 12,000 people are dying or becoming disabled each year because of a lack of specialist stroke units.

Its new campaign, Why are we Waiting?, being launched on November 13, asks why stroke patients always come bottom of the list of priorities in the NHS, despite stroke being one of the country's biggest killers.

Hospitals are failing to deliver on promises made to stroke patients by the Government's National Service Framework for Older People target, which said that stroke units would be opened by every hospital by April 2004.

"There are cardiac units in every hospital, so why not stroke units?," said Jerry Doyle, Director of PR at The Stroke Association. "People are dying because stroke is not always treated as the emergency it is. Stroke patients are left on general wards, where there is no specialist equipment or staff. There are delays in brain scans, and sometimes no brain scans at all. They deserve better treatment than this. It's a national scandal."

"Families of stroke patients should be told that their loved ones are at risk because of this. The loss of life and multiple disabilities being caused through this lack of specialist care is horrific."

" We ask the Government to tackle the Stroke postcode lottery in the same way they have announced they plan to address health inequalities in cancer services."

Even where there are stroke units, the picture is bleak. A newly released regional breakdown by the Royal College of Physicians shows that large numbers of stroke patients up and down the country are left out in the cold.

In the Thames Valley, for instance, more than 57% of hospitals were shown to have a stroke unit, but only 11% of stroke patients spent most of their hospital stay in one and 85% of stroke patients did not get into a stroke unit at all.

The situation in London (north central), where there are more stroke units than some other areas, is little better. Though 41% of stroke patients spend 50% or more of their time in a stroke unit, at least 55% of stroke patients never see the inside of a specialist unit.

Dame Deirdre Hine, Chair of the Commission for Health Improvement, confirmed the dire state of stroke services to this month's meeting of the All Party Group on Stroke at the House of Commons, saying that in the worst areas only 10% of people with stroke have access to a stroke unit.

Another confusion is that the NSF for Older People, which contains the stroke target, failed to give a proper definition of a stroke unit when it was first published in 2001/2. This has led to some hospitals claiming that stroke wards, without specialist equipment or staff, qualify as stroke units.

No distinction is made in the NSF, either, between acute and rehabilitation stroke units. In England there are many more rehabilitation units than acute stroke units in operation, leading to a lack of emergency care in most areas.

"Emergency care for stroke is more important than ever now that we have new clot-busting drugs that need to be given to patients within three hours," said Jerry Doyle. "Most people with stroke currently do not get this chance. Lives could be saved if we just got it right. We need stroke units that are large enough to cope, offering both acute and rehabilitation, with access to brain scanning equipment and staffed by multidisciplinary teams and a dedicated consultant."

"Where hospitals have made progress, it is because of the grit and determination of a few people. These Stroke Champions are the real NHS heroes and heroines, but we need a lot more of them to come forward if stroke patients are to be given the services they deserve."

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Notes to editor

· According to the government, 83% of hospitals are on target to have a specialised stroke service by the NSF deadline.

· Currently, only 36% of stroke patients spend any time in a specialist unit.

· The Stroke Association would like to see the national implementation of dedicated stroke services that provide clear care pathways from ambulance, through acute stroke care and rehabilitation, to GP-supported aftercare in the community.

· Stroke is one of the biggest killers and the largest single cause of serious adult disability in the UK. Around 100,000 people in England and Wales suffer a first stroke each year - about 10,000 are under the age of 55 and 1,000 are under the age of 30. One person every five minutes will suffer a first stroke.

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