To ask the Secretary of State for Health how many and what proportion of stroke patients were under 18 in each year since 1997. [126527]
The information requested is shown in the table.
| Finished Consultant Episodes: Count of in year admissions for primary diagnosis stroke (160–164 ICD 10) by age in NHS hospitals in England 1997–98 to 2001–02 | ||||
| Year | Under 18 | 18 and over | All ages | Percentage of under 18 |
| 1997–98 | 346 | 84,650 | 84,996 | 0.41 |
| 1998–99 | 342 | 87,986 | 88,328 | 0.39 |
| 1999–2000 | 340 | 86,742 | 87,082 | 0.39 |
| 2000–01 | 311 | 82,400 | 82,711 | 0.38 |
| 2001–02 | 297 | 83,347 | 83,644 | 0.36 |
Notes:
Source:
Hospital Episode Statistics (HES), Department of Health
To ask the Secretary of State for Health (1) what proportion of stroke patients were treated in a specialist unit in each strategic health authority, in each year since 1997; [126528](2) how many stroke patients did not receive a swallowing assessment within 24 hours of admission to hospital within the last year; and if he will make a statement; [126534](3) what the
(a) average and (b) maximum waiting times for stroke assessment after arrival at hospital were in each region in each year since 1997; [126535]
(4) how many and what percentage of general hospitals have had a specialist stroke unit in each year since 1997. [126542]
We do not collect routinely information on stroke services at the level of detail requested in these questions. The most comprehensive source of information is the National Sentinel Stroke Audit, carried out by the Royal College of Physicians. The audit was commissioned by the national health service in 1998 and was last updated in 2002. The results can be found at http://www.rcplondon.ac.uk/pubs/ strokeaudit0l–02.pdf. The audit contains information covering discharge arrangements, and clinical assessments including swallowing assessments. The 2002 audit shows that 73 per cent. of trusts who participated had a stroke unit, compared to 56 per cent. three years earlier. In addition, 83 per cent. of patients receive brain imaging (—the highest ever level. The audit shows that 80 per cent., of trusts that participated have a consultant physician with specialist knowledge of stroke who is formally recognised as having principal responsibility for stroke services. While it is recognised that some services need to increase their capacity, the audit notes that very significant improvements have already been made.Our major vehicle for further improving standards for stroke services is through the older people's national service framework (NSF), which sets specific milestones for improvement by 2004 of stroke services in primary care trusts, specialist services and general hospitals that care for people suffering from a stroke. Our document, "Improvement, Expansion and Reform", which sets for the national health service a Priorities and Planning Framework for 2003–06, makes clear that implementation of the older people's NSF is a top priority and that the 2004 milestone around specialist stroke services is a key target.We monitor progress against the key milestones in the NSF. From the information gathered so far we know that 83 per cent., of the hospitals which have replied now have plans to have a specialist stroke service in place by April 2004.Implementation of the NSF for older people is leading to real improvements in stroke services and making a difference to people's lives. The development of better services and improved standards in stroke care requires the right balance between national standards, provided by the NSF, national clinical guidelines and local control. It will be important to ensure that stroke care services are co-ordinated and fully integrated within a full range of other relevant local services.
To ask the Secretary of State for Health how many stroke physicians there are in hospital trusts; and if he will make a statement. [126529]
The Department does not collect data on stroke physicians; a number of specialties are linked with the treatment of patients with strokes.The main specialties are geriatric medicine, neurology and rehabilitation medicine but it is not possible to say how many of the physicians within these specialties specialise in the treatment of strokes.
To ask the Secretary of State for Health what estimate his Department has made of the cost of strokes to the NHS in each of the last five years. [126533]
The information requested is not collected centrally. Health authorities and primary care trusts receive unified allocations to cover the costs of hospital and community health services, discretionary funding for general practice staff, premises and computers and primary care prescribing.
The level of funding made available for the drugs, staffing and other costs of providing stroke services are determined locally. It is for health authorities in partnership with primary care groups/trusts and other local stakeholders to determine how best to use their funds to provide health services for their populations including those with stroke.
To ask the Secretary of State for Health (1) what monitoring is in place to ensure that NHS trusts have reviewed hospital services for stroke using the clinical audit methodology developed by the Royal College of Physicians; [126538](2) what monitoring is in place to ensure that NHS trusts have agreed local priorities for action required to establish an integrated stroke service which is regularly audited with a continuing cycle of improvement; [126539](3) whether every hospital which cares for older people with stroke has established clinical audit systems to ensure delivery of the Royal College of Physicians clinical guidelines for stroke care. [126540]
In 2001, the Third National Sentinel Audit of Stroke, carried out by the Clinical Effectiveness and Evaluation Unit of the Royal College of Physicians and led by the Intercollegiate Working Party for Stroke, gave a detailed picture of the way hospitals provide care for stroke patients. The results of this study were published July 2002.In the 2001 audit, 98 per cent. of eligible acute trusts submitted clinical data, demonstrating delivery of the clinical guidelines. The next National Sentinel Audit of Stroke is expected to take place in April 2004.The Department of Health will be monitoring formally the overall stroke milestone in April 2004 as this is included as one of the key targets in "Improvement, Expansion and Reform", the priorities and planning framework for 2003–06. It is now for strategic health authorities to plan, deliver and monitor progress locally on the other stroke milestones in the national service framework.Progress on this key target will be monitored through the 2003–04 local delivery plan reporting mechanism and information will be available later in the year.