Death risk fears over hold-ups at stroke units

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HUNDREDS of stroke victims in Lothian are not being admitted to specialist units on time, increasing their risk of death or disability.

Experts believe fast admission to the units is essential if patients are to have the best chance of survival and recovery following a stroke, which occurs when the blood supply to part of the brain is cut off.

But across NHS Lothian in February, 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 symptoms.

The Scottish Government has said that 90 per cent of stroke victims should be admitted to a unit within the timescale. The poor performance has led charities to call for urgent action to ensure all of the region’s 1000 stroke victims admitted to hospital each year have access to the expertise and treatment they need.

David Clark, chief executive of Chest, Heart and Stroke Scotland, said: “This is a matter of concern. This target has been set for a reason. There is a great deal of evidence to show that the faster someone is admitted to a specialist stroke unit the better the outcome.

“We have run a campaign throughout Scotland which encourages patients and 
relatives to treat strokes as medical emergencies. We are concerned if people are then not getting the right level of treatment in hospital.

“Some boards do meet this target so it is achievable. It’s disappointing that Lothian is below the target, particularly as it’s a major urban board. This should be a priority.”

Performance against the 90 per cent target has been consistently poor in recent months. It hit 67 per cent in February, 73 per cent in January, 59 per cent in December and 64 per cent in November.

The units, based at the Royal Infirmary, Western General and St John’s Hospital, offer staff who have been specifically trained in treating stroke patients and access to specialist equipment, including gyms.

Maddy Halliday, Scotland director of the Stroke Association, also expressed concern that the target was not being met in some areas.

She said: “Research shows that speedy admission to a stroke unit increases stroke patients’ chance of survival and improves their recovery.”

It is believed issues around delayed discharges and norovirus, which have left stroke and rehabilitation beds full or out of action, have added to pressure in the Lothian departments.

Melanie Hornett, NHS Lothian’s nurse director, said: “We are working hard to improve our performance in this area and have a thorough action plan in place to help us achieve the target set. There are stroke outreach nurses based at each of our adult acute hospital sites to deal with patients who haven’t been admitted to a stroke unit. In cases where a stroke unit bed is not immediately available patients are admitted to a suitable ward and the stroke outreach nurse is alerted to their presence.

“Outreach nurses liaise with all departments and ensure that stroke patients receive the most appropriate assessments and care.

“We are currently reviewing our discharging processes for stroke patients.”