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Strokes

Volume 491: debated on Wednesday 22 April 2009

To ask the Secretary of State for Health what guidance his Department issues to acute care units on the emergency classifications of stroke; and if he will make a statement. (268911)

Guidance to the national health service on stroke care is contained in the national stroke strategy. In addition, stroke is a priority area for the NHS and there is a Tier 1 Vital Sign covering the time stroke patients spend in a stroke unit and the percentage of higher risk transient ischaemic attack patients who are treated within 24 hours.

This Vital Sign is a new data collection. Following the first two quarters of data and at the request of the NHS, the vital signs guidance was revised to help improve data accuracy. This included aligning the International Classification of Diseases codes with the Sentinel Audit and clearer definitions. This revised Guidance was made available to the NHS on 27 March 2009 and a copy has been placed in the Library.

To ask the Secretary of State for Health how many specialised stroke units there are in England; and what his plans are for the future numbers of such units. (268912)

The latest National Sentinel Stroke Audit conducted by the Royal College of Physicians, identifies 186 stroke units in England. The planning of appropriate stroke services is a matter for decision locally.

To ask the Secretary of State for Health how many stroke patients have been treated in specialised units in each of the last three years for which figures are available. (268913)

To ask the Secretary of State for Health what steps his Department is taking to increase patient access to (a) diagnostic scans and (b) thrombolysis for those whose stroke was caused by a blood clot; and if he will make a statement. (268914)

Stroke is included as a priority for the national health service in the operating framework. The stroke strategy recommends that everyone who can benefit from urgent stroke care should be transferred to an acute stroke centre that provides 24-hour access to scans and specialist stroke care. All hospitals now provide computed axial tomography scanning and most provide magnetic resonance imaging and carotid doppler too. The Department published an imaging guide in 2008, to help ensure that imaging services develop in line with the quality markers in the national stroke strategy. A copy has been placed in the Library. The guide has been welcomed by the profession. The latest National Sentinel Audit of stroke from the Royal College of Physicians shows that the number of stroke units providing thrombolysis is increasing. However, provision of these services out of hours remains a challenge. Local stroke networks have been established to assist in reviewing and organising the delivery of improved stroke services. This includes ensuring access to scanning and the provision of thrombolysis where appropriate.

To ask the Secretary of State for Health what steps his Department is taking to ensure that patients with suspected stroke or transient ischaemic attack receive (a) rapid assessment, (b) access to imaging and (c) necessary treatment. (268915)

Stroke is included as a priority for the national health service in the operating framework.

Those with a suspected stroke or transient ischaemic attack (TIA or minor stroke) should immediately be referred for appropriate, urgent, specialist assessment and investigation including access to imaging and necessary treatment. The stroke strategy recommends that local referral protocols should be agreed between primary and secondary care to facilitate the timely assessment of people who have had a suspected TIA. The Department published an imaging guide in 2008, to help ensure that imaging services develop in line with the quality markers in the national stroke strategy. The guide has been welcomed by the profession. A copy has already been placed in the Library.

The strategy also recommends that people with suspected acute stroke should be transferred immediately by ambulance to a receiving hospital that provides hyper-acute stroke services including expert clinical assessment, timely imaging and intravenous thrombolysis over 24-hours. Local stroke networks have been established to assist in the reviewing and organising of the delivery of improved stroke services across the pathway.

This includes assessment, imaging and appropriate follow up treatment.

To ask the Secretary of State for Health what assessment he has made of patients' ability to obtain stroke services in rural areas; and what steps he is taking to increase access to stroke services for patients in rural areas. (268916)

Ensuring that people have access to appropriate stroke services is a matter for the national health service locally. In rural areas, this could include the development of tele-radiology and tele-medicine. We have set up the Stroke Improvement programme and local stroke care networks to support the NHS to deliver world class stroke services.