Stroke patients put at risk by delays in specialist care

The Royal Infirmary has staff specifically trained in treating stroke patients and access to specialist equipment. Picture: Jon Savage

The Royal Infirmary has staff specifically trained in treating stroke patients and access to specialist equipment. Picture: Jon Savage

0
Have your say

HUNDREDS of stroke patients in Lothian are being put at risk after health chiefs missed treatment targets again.

Experts have long emphasised the importance of patients being admitted to specialist units as quickly as possible to boost their chances of survival and improve their prognosis once discharged.

But during February and March, more than a third of patients were not admitted to a specialist department on the same day they were admitted to hospital, or the day following their arrival at a GP surgery or hospital with stroke symptoms.

Health Improvement Scotland targets suggest 90 per cent of stroke patients should be admitted within a day. But the health board has repeatedly failed to ensure this, with only 55 of 94 sufferers transferred within the timescale in March. It also fell below the mark in terms of swallow assessments – used to check for ­possible paralysis – but nearly all patients were given a brain scan within the allotted time.

Potentially life-saving ­clot-busting treatment, known as thrombolysis, is often not given in its effective period.

The latest figures have been released by the board as the Scottish Stroke Care Audit findings were released. Stroke Association Scotland, champions of FAST (Face, Arms, Speech, Time – the NHS directive to help people notice stroke signals) said it was vital for the signs of stroke then treatment to happen quickly.

A spokesman said: “When someone has a stroke it is 
vital that they get to a specialist stroke unit as soon as possible.

“In cases where a stroke is caused by a clot, some patients can benefit from a clot-busting treatment called thrombolysis which works to dissolve the clot and reduce the amount of brain damage. This drug must be administered within 4.5 hours of stroke onset and benefits about one in six treated.”

About 1000 patients a year in the region are believed to suffer a stroke, which occurs when the blood supply to part of the brain is cut off.

The units, based at the Royal Infirmary, Western General and St John’s Hospital, have staff specifically trained in treating stroke patients and access to specialist equipment. Issues around delayed discharges, which have left stroke and rehabilitation beds full or out of action, have added to pressure in these departments.

Melanie Johnson, director of unscheduled Care for NHS Lothian, said stroke services were under review. She said: “We’ve made steady progress over the last year to improve patient care in five of the six measures of stroke care quality, but we recognise we have to improve access to a stroke unit within 24 hours to urgently improve standards of care.

“As a result, we have already begun exploring options within unscheduled care and are awaiting the outcomes from a redesign workshop to help bring about change.”

kate.pickles@edinburghnews.com