Stroke victims facing deadly lottery

STROKE victims face a postcode lottery in access to treatment that could place their long-term health in jeopardy, MPs warned yesterday.

The Commons Public Accounts Committee claimed it was "totally unacceptable" that the chances of receiving a timely scan or specialist care were dependent on where and when patients suffered a stroke.

A stroke patient in London was likely to have a scan within three hours and certainly within 24 hours, while patients in Grimsby had to wait up to 48 hours – increasing the likelihood of complications and long-term disability.

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In their report, MPs also warned that many patients discharged from hospitals struggled to get follow-up care.

The study criticised "extremely wide variations" in some regions in numbers of patients receiving the best care and, in its evidence, even the Department of Health acknowledged that the worst performers were "an embarrassment".

Some hospitals were failing to overcome "avoidable" obstacles to care on dedicated stroke units where in some cases beds where occupied by patients with other conditions.

At the end of 2009, figures show 57 per cent of patients in Yorkshire spent 90 per cent of their time on a stroke unit compared to more than 70 per cent in the North East and barely 50 per cent in the South West – all well below the Government target of 90 per cent.

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The proportion varied from just 27 per cent in Hull to 82 per cent in Calderdale.

The cross-party committee said some hospitals, including the Diana Princess of Wales Hospital in Grimsby, had unacceptably high waiting times for scans.

This was because some scanners were being locked away out of hours, even though there were radiographers present who were capable of interpreting the scans.

The MPs also pointed to slow implementation of video link-ups in areas where scans had to be interpreted outside the hospital. There was also a lack of "pre-alert systems" to inform hospitals in advance of the arrival of stroke patients.

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They also warned that access to community rehabilitation services for discharged patients remained a postcode lottery. There was a risk that the current level of these services would not be sustained once funding given to councils to help implement the Department of Health's stroke strategy came to an end next year.

But the committee said there had been marked improvements in stroke care and awareness since its highly critical report on the Government's performance in this area in 2006.

The department had increased the priority given to strokes, particularly the speed of the acute hospital response, and its "excellent" media campaign, Stroke – Act FAST, had an important impact.

The committee chairman, Tory MP Edward Leigh, said there had been "demonstrable improvements" in hospital care for strokes. But he added: "It is totally unacceptable that the likelihood of receiving a timely brain scan or accessing specialist care depends on where and when you have a stroke. In 2008, of all patients with suspected stroke, only three-fifths had been scanned within 24 hours.

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"It is also worrying that, despite every hospital having a specialist stroke unit, too many stroke patients fail to be admitted to units quickly enough or spend enough time on the units."

More than 110,000 people have strokes in England each year. A stroke occurs when blood flow to the brain is interrupted, resulting in damage to brain tissue. It is one of the top three causes of death and the largest cause of adult disability in England, costing the NHS at least 3bn a year in direct care costs.

Cuts 'hitting nurse training'

Nurses are missing out on vital training, including basic life-support and managing infections like MRSA, a poll found.

A survey of more than 3,000 nurses for the Royal College of Nursing (RCN) found 32 per cent had been unable to attend compulsory training this year. Of those, 44 per cent cited staff shortages and a lack of cover as key reasons why they could not attend.

The RCN said cutbacks meant nurses were being forced to train in their own time.