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Stroke Care Needs Improving

Hospitals are failing to care for stroke patients due to major shortages in doctors and nurses according to two reports.

The SSNAP Annual Reportand SSNAP Acute Organisational Audit 2014 commissioned by the Sentinel Stroke National Audit Programme (SSNAP) show that 25% of hospitals have unfilled stoke consultancy positions and only 27% have the appropriate level of specialist nursing care.

It is recommended that for every 10 patients there should be three specialist members of nursing staff.

The overall research is worrying as death rates are lower when stroke wards have higher numbers of nurses, and death rates for acutely ill patients are lower when there are more doctors available at nights and at weekends.

Dr Peter Carter, Chief Executive of the Royal College of Nursing, said: “It's unacceptable that so many hospitals are still failing to make sure they have enough nurses on duty to care for stroke patients.

“There's overwhelming evidence that the number of registered nurses on a ward is strongly linked to stroke patients' outcomes. If a hospital has enough nurses in place, stroke patients are more likely to survive and to recover.

“While the reorganisation of acute stroke service has led to some notable improvements, it's indisputable that only with the right number of nurses, with the right skills, can hospitals ensure that stroke patients receive the highest quality of care. The NHS needs to invest in its nursing workforce so that it can provide safe staffing levels for every health setting.”

Despite this, there are some improvements in the level of care offered to stroke sufferers with 75% of hospitals having access to early discharge services and most hospitals offering 24/7 drug access.

The audit was commissioned by the Healthcare Quality Improvement Partnership on behalf of NHS England as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP), and run by the Clinical Effectiveness and Evaluation Unit of the Royal College of Physicians (RCP). 

The publication of the reports coincide with the UK Stroke Forum which starts today.

Professor Tony Rudd chair of the Intercollegiate Stroke Network, said “'It is fantastic having such high quality data available to the public and professionals describing the current state of stroke care. 

“Clearly care is improving but we must not be complacent. There are still too many patients receiving sub-optimal care. To correct these issues we need more stroke consultants and services that deliver treatment seven days a week.”

Figures from the Health and Social Information Centre (HSIC) have also show a distinct difference in the quality of care receives between regions. 

In 71 of the 211 CCGs across the country, less than 55 per cent of patients were admitted to a stroke unit within four hours of admission to hospital and in 13 CCGs, this figure was less than 40 per cent. No CCGs were able to ensure that 90 per cent or more of their patients were admitted to a stroke unit within four hours of admission to hospital.

HSCIC Chair Kingsley Manning said: "It is important that patients suffering a stroke receive appropriate care as soon as possible. I'm sure health professionals and those responsible for delivering care for stroke patients will use this report to identify how improvements in treatment can be made, such as how quickly patients are admitted to a stroke unit.

"The other new indicators in the report on hip fracture and mental health will also be helpful to CCGs in forming their commissioning plans.”