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Strokes

Volume 461: debated on Thursday 21 June 2007

To ask the Secretary of State for Health if she will increase the availability of (a) acute stroke services available within three hours and (b) other specialist treatment for people suffering from strokes; and if she will make a statement. (143947)

To ask the Secretary of State for Health what measures are in place to ensure that every primary care trust area has a service for diagnosis and treatment of a stroke within three hours of symptom onset; and when she expects this to be in place. (143030)

The rapid diagnosis of stroke and the introduction of thrombolysis (the use of clot-busting drugs) are key challenges for the national health service in its treatment of stroke. This is why the Department is developing a new national stroke strategy for England, which aims to support the NHS to modernise services and deliver the newest treatments for stroke.

To ask the Secretary of State for Health what timetable is in place to provide an acute stroke service in every primary care trust area; and if she will make a statement. (142969)

All primary care trusts caring for people who have had a stroke now have a specialist stroke service and 97 per cent. (196 of 203 hospitals) of hospitals in England who treat stroke patients now have a stroke unit (in 2004 only 82 per cent. had a stroke unit).

Source:

National Sentinel Audit for Stroke 2006 conducted by the Royal College of Physicians.

To ask the Secretary of State for Health what assessment she has made of the trend in the number of strokes amongst people in England. (143006)

To ask the Secretary of State for Health when she expects the national stroke strategy to be published. (145043)

The Government are currently developing a new national stroke strategy for England which aims to modernise services and deliver the newest treatments for stroke, and the aim is to publish it this winter, following a full public consultation.

To ask the Secretary of State for Health what steps she is taking to reduce the number of deaths caused by strokes. (143025)

Stroke mortality is falling. For people under 65, the three year average death rate from stroke has fallen by 23 per cent. over the period from 1993-95 to 2002-04. For people aged 65-75 the death rate has dropped by 30 per cent. over the same period. However, the Government recognise that more needs to be done. This is why we are developing a new national stroke strategy for England which will modernise services and deliver the newest treatments for stroke. The strategy will be published for consultation shortly with the intention of the final version being available by the end of the year.

To ask the Secretary of State for Health what steps she plans to take to prevent avoidable deaths from stroke in England; and if she will make a statement. (143946)

Stroke mortality is falling. For people under 65, the three-year average death rate from stroke has fallen by 23 per cent. over the period from 1993-95 to 2002-04. For people aged 65 to 75, the death rate has dropped by 30 per cent. over the same period.

The risk factors which increase an individual’s chances of suffering a stroke include smoking, drinking alcohol, poor diet and lack of physical activity. Strokes are also more likely in those who suffer from hypertension and diabetes. Through the public health White Paper “Choosing Health”, the Department has set out a programme of action to help improve the health of the public including action on smoking and diet. This builds on existing work such as campaigns on smoking and diet, National Institute for Health and Clinical Excellence guidelines on the management of hypertension, points for prevention activities in the general practitioner contract and support for the Blood Pressure Association blood pressure awareness campaigns.

The coronary heart disease and diabetes national service frameworks have also driven forward improvements in primary and secondary prevention of risk factors associated with circulatory disease in general. This includes better control of blood pressure and blood glucose, cholesterol management and the use of aspirin.

The Department is also developing a new national stroke strategy for England which aims to modernise services, not just for those who have had a stroke, but also those at risk of doing so.

To ask the Secretary of State for Health if she will provide funding for research into the prevention and treatment of stroke in people of (a) African Caribbean and (b) South Asian origin. (143972)

Over the last 10 years, the main part of the Department's total expenditure on health research has been devolved to and managed by national health service organisations. Details of individual NHS supported research projects including a number relevant to my hon. Friend's question are available on the national research register at

www.dh.gov.uk/research.

The Department's National Institute for Health Research is investing £20 million over five years in the UK Stroke Research Network set up in 2005. The Network is supporting clinical trials and other well designed studies conducted by public and private sector funders, and has adopted the following three studies which involve research into the prevention and treatment of stroke within black and minority ethnic communities:

DNA resource for lacunar stroke

South London ethnicity and stroke study

The South London secondary prevention programme

The Department is also funding the South London Stroke register which assesses the risk of stroke and the natural history of stroke with a focus on ethnicity.

To ask the Secretary of State for Health which NHS trusts in London provide acute stroke services. (143020)

The Department does not hold this information centrally. However, the following hospitals took part in the 2006 sentinel audit of stroke services conducted by the Healthcare Commission.

NHS Trusts

Barking, Havering and Redbridge Hospitals NHS Trust (Oldchurch and Harold Wood hospitals in collaboration with Havering primary care trust)

Barnet and Chase Farm Hospitals NHS Trust (Barnet hospital), Barnet PCT and Finchley Memorial hospital

Barnet and Chase Farm Hospitals NHS Trust (Chase Farm hospital)

Barts and the London NHS Trust jointly with Tower Hamlets PCT

Bromley Hospitals NHS Trust

Ealing Hospital NHS Trust

Epsom and St. Helier University Hospitals NHS Trust (Epsom Hospital)

Epsom and St. Helier University Hospitals NHS Trust (St. Helier Hospital)

Hammersmith Hospitals NHS Trust

Hillingdon Hospital NHS Trust

Kingston Hospital NHS Trust

Lewisham Hospital NHS Trust

Mayday Healthcare NHS Trust

Newham University Hospital NHS Trust

North Middlesex University Hospital NHS Trust—Jointly with Haringey PCT

North West London Hospitals NHS Trust (Central Middlesex Hospital including Willesden Community hospital (Brent PCT))

North West London Hospitals NHS Trust (Northwick Park Hospital)

Queen Elizabeth Hospital NHS Trust

Queen Mary’s Sidcup NHS Trust

Royal Free Hampstead NHS Trust

St. George's Healthcare NHS Trust

St. Mary’s NHS Trust

West Middlesex University Hospital NHS Trust

Whipps Cross University Hospital NHS Trust

Whittington Hospital NHS Trust

NHS trusts in 2006, now foundation trusts:

King’s College Hospital NHS Foundation Trust

Foundation trusts in 2006

Chelsea and Westminster Hospital NHS Foundation Trust

Guy’s and St. Thomas Hospital NHS Foundation Trust

Homerton University Hospital NHS Foundation Trust

University College London Hospitals NHS Foundation Trust

To ask the Secretary of State for Health what steps her Department has taken to ensure a comprehensive acute (a) stroke service and (b) recovery service in Sutton and Merton Primary Care Trust area. (143009)

This is a local issue. NHS London is working to improve stroke care in London, and this is one of the issues being dealt with by the long-term strategy for London being led by Professor Sir Ara Darzi. The Royal College’s National Stroke Guidelines are for a scan to be provided within 24 hours (and within three hours where a thrombolysis service is provided).

To ask the Secretary of State for Health how many (a) brain scanners and (b) specialist radiologists are available in Sutton and Merton Primary Care Trust for the diagnosis of acute stroke within three hours of the onset of symptoms. (143153)

NHS London has advised that the majority of Sutton and Merton Primary Care Trust (PCT) patients are treated at St. George’s Hospital and St. Helier Hospital, which also provide services for other PCTs. St. Helier has one CT scanner, one MRI scanner and 10 radiologists. St. George’s has three CT scanners, and most of the reporting is carried out by five neuro-radiologists.

To ask the Secretary of State for Health how many Wimbledon residents are in receipt of treatment for strokes. (143008)

Information is not collected in the format requested. The following table shows the number of all diagnoses count of finished consultant episodes with Sutton and Merton PCT as primary care trusts of residence for strokes (which covers the Wimbledon area).

PCT description

Finished consultant episodes (FCE)

Sutton and Merton PCT

1,241

Notes:

All Diagnoses count of episodes

These figures represent a count of all FCEs where the diagnosis was mentioned in any of the 14 (7 prior to 2002-03) diagnosis fields in a HES record.

FCE

An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. Please note that the figures do not represent the number of patients, as a person may have more than one episode of care within the year.

Ungrossed Data

Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).

Source:

Hospital Episode Statistics (HES), The Information Centre for health and social care