UK stroke services ‘worst in western Europe’

The UK needs to quickly improve stroke services or they will remain the worst in western Europe, a leading doctor reported in the British Medical Journal.* Professor Hugh Markus from London’s St George’s Medical School, said that patients are not treated with sufficient priority and the condition is seen as a “Cinderella” subject in the UK compared to other European countries.

The latest audit of stroke services, by the Royal College of Physicians, found that less than twothirds of patients were given a bed on a specialist stroke unit. In addition, while in many European countries brain scans are performed on admission to A&E, many UK units struggle to provide scans within 24 hours. This is despite research showing that scanning patients immediately is the most cost effective strategy. Outside the UK, in some centres as many as 20-30% of eligible patients receive thrombolytic therapy. This is compared to less than 1% in the UK, he added.

Improved early diagnosis with imaging, along with improved monitoring and treatment, will improve outcome independent of administration of thrombolysis he concluded.

His comments followed an earlier report, by the National Audit Office report in 2005, which suggested that 550 deaths could be avoided and an extra 1,700 patients make a full recovery if care was better organised.

Joe Korner, director of communications at The Stroke Association responded to the comments by Prof Markus, stating: “It is vital that stroke gets the priority and investment it needs – without investment hundreds will die needlessly. Public awareness of stroke also needs to be increased so that people can recognise the warning signs of a stroke and dial 999 immediately. It is unacceptable that at the present time, for people who have a stroke in the UK, their prospects are far bleaker than in other countries.”

* Improving the outcome of stroke, BMJ Volume 335 pp 359-60.

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