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Stroke services in Wales still struggle to match rest of UK; Assembly health committee calls for dedicated wards for patients.

Byline: Madeleine Brindley

STROKE services in Wales are continuing to lag worryingly behind the rest of the UK, an inquiry has found.

A hard-hitting report by the National Assembly's health committee will today call for all stroke patients to be admitted to dedicated beds instead of general wards.

It wants Health Minister Edwina Hart to develop a national stroke strategy, which includes targets and deadlines and appoint stroke champions to lead improvements in services.

And the committee's report raises concerns that the level of funding for stroke in Wales does not match the investment made in other parts of the UK.

In all there are 25 recommendations to improve the care that all patients receive in Wales after suffering a stroke.

The committee's inquiry into stroke services followed a series of damning audits by the Royal College of Physicians.

Darran Millar, the committee chairman, said: "Unfortunately, our inquiry has shown that some of the original concerns outlined by these external audits have yet to be addressed, although some improvements have been made. "Strokes are the third most common cause of death, and given that evidence shows specific service improvements can decrease patient mortality and disability, it is vital that our recommendations are acted upon to improve services for those affected by strokes.

"The committee urges the Assembly Government to consider establishing an all-Wales stroke strategy led by stroke champions or team leaders who can tackle these issues and bring Welsh services up to the same level as the rest of the UK."

The last National Sentinel Audit for Stroke said although there had been some improvements, Welsh stroke services were still behind the rest of the UK.

The 2008 audit, which was published last year, said just 41% of patients are treated for the majority of the time on a dedicated stroke unit, compared to 59% in England.

And only 43% of patients had been assessed by an occupational therapist within four days of admission.

In Northern Ireland the figure was 73%.

The audit report said: "Standards of care for all of the key indicators, apart from starting aspirin within 48 hours, remain lower in Wales than England and Northern Ireland.

"Until specialist stroke units are made available in all hospitals in Wales and are of sufficient capacity to manage all appropriate patients this situation is unlikely to be rectified.

"It is encouraging that the Welsh Assembly [Government] is making efforts to address the issue. There is clearly a need for urgent action."

Some 11,000 people suffer a stroke every year in Wales - a third will die and a third will suffer permanent disability.

The inquiry and the subsequent report has highlighted the need for all patients to be treated in dedicated stroke units - only half of Welsh hospitals have stroke units, compared to 90% in England, according to the Stroke Association Giving evidence to the committee inquiry, Dr Hamsaraj Shetty, who is based at the regional stroke unit in Cardiff, said: "Managing stroke patients in a specialised multi-disciplinary stroke unit has been shown to reduce death and dependency.

"This is the only intervention used to manage stroke patients that has been shown to be associated with a reduction in mortality."

But the inquiry discovered that despite such clinical evidence many patients are admitted onto general wards.

The Welsh Stroke Nurse Alliance said this was in contravention of national guidelines.

Responding to the committee's report today, Ana Palazon, the Stroke Association's director for Wales, said: "The publication of this report calls for a strategy and makes 25 long-awaited and necessary recommendations covering prevention, acute care, early and continued rehabilitation, as well as the need for research leadership and funding.

"However, any credible stroke services strategy must be linked up to a wider strategy for tackling health inequalities and longerterm social care needs.

"We look to a commitment from the Welsh Government to an outcome-based, all-Wales strategic approach, underpinned by realistic resources."

An Assembly Government spokeswoman said: "Health Minister Edwina Hart will consider the findings and recommendations of the report and respond in full to the committee in due course."

more Health Wales: pages 22-27
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Publication:Western Mail (Cardiff, Wales)
Geographic Code:4EUUK
Date:Apr 19, 2010
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