NHS 'is failing stroke patients'
Updated on 05 June 2009
The NHS is failing 90 per cent of patients who should have emergency surgery following a minor stroke, according to an audit in the British Medical Journal.
The government's National Stroke Strategy, launched in December 2007, calls for appropriate surgery within 48 hours of a minor stroke. However the audit finds 90 per cent of patients in Britain fail to get the operation that quickly. 80 per cent are not operated on within the two-week minimum recommended by health watchdog NICE.
"These patients need to be fast tracked through the emergency system and treated at the same level of priority as patients with other life threatening illnesses," says Tim Lees, a consultant vascular surgeon at the Freeman Hospital in Newcastle and one of the authors of the BMJ report.
"If a patient is exhibiting symptoms of stroke they should be investigated and treated as quickly as possible."
Around 90,000 people suffer a serious stroke each year, making it the largest cause of serious adult disability. The after-effects of stroke are estimated to cost the economy £7 bn yearly and £2.8bn in direct hospital care.
The operation, called carotid endarterectomy, or CEA, removes blood clots that form in the main artery in the neck leading to the brain. Small particles breaking away from these clots are often the cause of mini-strokes. A mini-stroke is often the first warning sign that the entire clot may dislodge causing a major life-threatening or debilitating stroke -- often within days. Removing the blood clot dramatically reduces the risk of a subsequent major stroke.
A third of patients covered by the audit waited more than 12 weeks to receive CEA. By this point, argue surgeons, the benefits of surgery are minimal and the opportunity to prevent another stroke is eliminated.
In a statement, the Department of Health told Channel 4 News: "The cases quoted in this study were taken between 2005-07, before we launched the Stroke Strategy in December 2007. As well as making clear that stroke is an emergency that must be treated quickly, the Stroke Strategy sets high standards for all aspects of treatment, care and support for stroke survivors and their carers."
But getting all minor stroke cases who require the operation to a surgeon within 48 hours will be a challenge. Tom Loosemore, a vascular surgeon at St George's Hospital in London, told Channel 4 News: "We're going to need a system where people get referred through much quicker and there are bigger units with a vascular surgeon and the necessary support staff available to actually perform these operations."
