Department of Health and Social Care
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Faster stroke treatment will save thousands of lives
- New stroke strategy includes £105m for extra training posts and raising awareness -
Anyone in a higher-risk group who suffers a minor stroke will receive an MRI scan within 24 hours under plans to revolutionise stroke services unveiled by the Health Secretary Alan Johnson today.
The strategy aims to accelerate the emergency response to stroke, by setting out a framework for care for those affected by stroke and raising awareness about symptoms and risk factors. By following the actions set out in the strategy, up to 6,800 deaths and cases of disability could be avoided every year. A further 1,600 strokes could be averted through preventative work.
Key measures include:
- MRI scans for higher-risk* individuals with Transient Ischaemic Attack (TIA) - also known as 'minor strokes' - within 24hrs of experiencing symptoms. Within seven days for low-risk individuals. This could lead to an 80 per cent reduction in the number of people who go on to have a full stroke. Currently, less than 35 per cent of providers manage to treat TIA within seven days.
- Immediate transfer of those with suspected stroke to a specialist centre offering immediate clinical assessment, scans and clot-busting drugs. All local areas will have 24/7 coverage by at least one specialist centre.
- Those with stroke requiring urgent brain imaging scanned within the next scan slot during normal working hours, and within 60mins out of hours.
- All individuals with stroke must spend the majority of their time on a stroke unit.
- People affected by stroke and their carers should have immediate access to high quality rehabilitation and support from stroke-skilled services in hospital, allowing people to get home faster. This specialist care should continue for as long as it is needed.
Alan Johnson said:
"This is a bold vision for the delivery of world-class stroke services, from prevention right through to life-long support. There is no excuse for standing still. Stroke is the third biggest killer in England, with 50,000 people dying from it each year. It also has a devastating and lasting impact on the lives of those who do survive, with a third left with long-term disability.
"We have made great strides with stroke, heart disease and cancer in recent years. However, despite the considerable gains in developing stroke units and falling mortality rates, there remains much to be done to bring stroke services in line with those for cancer and heart disease. Now is the time to close that gap. We can and we must now give stroke the attention it deserves. Saving thousands of lives is a prize too great to ignore."
Thanks to record investment over the last ten years, the NHS has the resources to fund changes to stroke services. In addition to this, the Government has committed central funds totalling £105m to provide national support for improving stroke services. Spending proposals include:
- Training for stroke consultants, nurses and allied health professionals (AHPs). The package includes funding for an additional 30 stroke specialist physician training posts in 2008-2009. (£16m)
- Activity to raise awareness of stroke nationally. (£12m)
- The development of acute and community demonstration sites to pioneer best practice. (£77m)
Professor Roger Boyle, National Clinical Director for Stroke and Heart Disease, said:
"Prevention is better than cure. That is why raising awareness of how to prevent stroke through healthy living is at the heart of the strategy.
"We also need the public and health & social care professionals to recognise stroke symptoms more effectively. There is only a three-hour window for the use of clot-busting drugs. This means acting fast.
"Treating stroke as an emergency will save lives. Working across new stroke networks, we need to pool the talents of doctors, nurses and therapists who are already working tirelessly to improve care of those with stroke. Ensuring 24/7 coverage of acute stroke care capable of delivering clot-busting drugs could see more than 1,000 people a year regaining independence rather than die or face long-term dependency."
Jon Barrick, Chief Executive of the Stroke Association, said: "This is a historic time for stroke - no longer will stroke be seen as an inevitable, untreatable consequence of old age. This is a momentous opportunity to transform the outcomes and lives of stroke survivors in this country. This strategy has been developed in cooperation with so many stakeholders who care greatly about improving stroke care, and sets out the vision that all stroke survivors and their families will recognise as the world-class stroke care they deserve. I am looking forward to working with Roger Boyle and his team in taking this forward."
Notes to editors:
1. Copies of the stroke strategy are available on the Department of Health website: http://www.dh.gov.uk/stroke
2. The strategy has been developed with the support and hardwork of a wide range of stakeholders, including people who have themselves experienced stroke. A consultation ended on 12 October 2007 and the Department received more than 1,000 responses.
3. In line with the health reform aims of greater devolution leading to greater local decision making to reflect local priorities, the strategy does not set national targets or milestones. New stroke networks - typically covering a population of 0.5 million and 2 million - will be established to drive forward improvements. These networks will be supported nationally.
4. The strategy sets clear goals which NHS commissioners are expected to meet over the next ten years. However, we would expect to see noticeable progress over the next three years. The National Stroke Sentinel Audit will continue to measure key aspects of stroke care.
5. Stroke is a blood clot or bleed in the brain which can leave lasting damage affecting mobility, cognition, sight or communication. They have a major impact on the nation's health and economy and are the third biggest cause of death in the UK and the largest single cause of severe disability. Each year more than 110,000 people in England will suffer from a stroke which costs the NHS over £2.8 billion. Every five minutes someone in the UK has a stroke.
6. A stroke can be diagnosed by using FAST - Facial weakness, Arm weakness, Speech Problems, Test all three. If someone has these symptoms you should call an ambulance straight away.
7. *The definition of a "higher-risk" individual is in line with NICE guidelines and uses the ABCD2 score system. The score is calculated using the patient's age (A); blood pressure (B); clinical features (C); and duration of TIA Symptoms (D) and presence of diabetes (2). Those individuals with a score of four or more are considered the priority group to treat.
8. Mortality rates are falling: for people under 65, the three year average death rate from stroke has fallen by 23% from 1993-95 to 2002-04, and for people 65-75 the death rate has dropped by 30% over the same period.