Stroke care in Wales could be significantly improved – report

Despite making improvements, Wales has a long way to go to make our care for stroke patients as good as the best in Europe, says the chief medical officer.
Stroke death rates in Wales still lag behind other European nations said Dr Ruth Hussey in her first annual report on the condition.

It comes as Health Minister Mark Drakeford opens a new £11m rehabilitation centre in Cardiff.

He said there had been “huge strides” in treatment.

But Stroke Association Wales said improvements had been slow despite three earlier reports.

A stroke occurs when the blood supply to part of the brain is cut off.

Deprived communities

About 11,000 people have a stroke each year in Wales, making it the fourth biggest health killer after cancer, heart disease and respiratory disease. In 2010 it caused almost 2,800 deaths.

But Dr Hussey’s report shows progress in key areas, including both a fall in the death rate from strokes and emergency hospital admissions for the condition.

“However, inequalities remain and we are concerned about the higher number of people who suffer from a stroke amongst our more deprived communities.

“The prevalence and mortality rate is considerably higher in men and those aged over 65.”

About stroke care, which refers to both prevention and treatment, the report added: “International comparisons show that quality of stroke care in Wales could be improved significantly.

“Both England and Wales lag behind comparable countries for rates of mortality, the availability of skilled facilities and in access to treatments that have been shown to improve outcomes vary across Wales.”

The report adds: “There is a lot to be done if we are to close the gaps within Wales and between Wales and the most successful European countries.”

‘Huge strides’

Dr Drakeford said there had been “huge strides” in the treatment of strokes.

“We have invested almost £350,000 over the past three years to support the all Wales out-of-hours Telestroke service,” said the minister, ahead of the official opening of the stroke rehabilitation unit at Llandough Hospital.

“Also, we have increased focus on thrombolysis, the use of drugs that breaks up clots in the blood, which is recognised as a vitally important.

“For the first time we are able to review how stroke services are performing at a local and national level.

“This annual report highlights the progress we have made and identifies areas for future improvement – and I cannot think of a better day to publish than on World Stroke Day.”

But Conservative health spokesman Darren Millar said while additional investment in stroke care was welcome, persistent evidence had shown that patient outcomes in Wales continued to lag behind other parts of the UK.

“Evidence has shown that immediate treatment is the major factor in securing a successful recovery and until Labour ministers address ambulance failings, delayed hospital transfers as well as staffing pressures, stroke patients may not receive the timely treatment they require,” he said.

Claire O’Shea, from Stroke Association Wales, said despite previous reports improvements had not come fast enough.

“It’s definitely a lack of resource,” she told BBC Radio Wales.

“There are individuals within the NHS in Wales who are working really hard to drive up standards but at the moment they need more resource, they probably need more finance.

“We’ve had three inquiries into strokes in recent years and there has been little progress made after each one.”

KEY FINDINGS

•     International comparisons show that quality of stroke care in Wales could be improved significantly.
•     The pace of improvement experienced in Wales since 2010 is higher than that noted in England and Northern Ireland.
•     Good progress has been made in developing thrombolysis services after minimal provision two years ago
•     Deaths from stroke among those admitted to hospital with stroke have fallen by 3.9% since 2006/ 2007 from 22.4% to 18.5% in 2012/2013
•     30 day hospital survival rates for stroke patients have shown a modest improvement since 2007/2008

Source: Stroke annual report for Welsh government