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Rapid GP referrals for stroke and TIA urged

By Nigel Praities

GPs are urged to accelerate referrals for patients with suspected strokes or a transient ischemic attacks, under new guidelines released by NICE and the Royal College of Physicians.

The new guidelines say patients with a suspected stroke should be assessed and immediately admitted to a specialist stroke unit.

Those with a suspected high-risk TIA – an ABCD2 score of 4 or above – should have aspirin 300 mg per day initiated immediately and should receive specialist assessment within 24 hours.

The new guidance follows criticism of the waiting times for patients with stroke and TIA, with a study published last year showing an average delay of 15 days before TIA patients were seen by a specialist.

Dr Tony Rudd, chair of the guideline development group and consultant stroke physician at St Thomas' Hospital, London, said GPs in some areas had ‘given up' on referring patients for TIA because their local hospital provided 'such a bad service'.

‘The pathways need to be made as easy as possible. GPs need to be able to make one phone call or one fax to get patients with a TIA into a clinic within 24 hours,' he said.

Dr Stewart Findlay, treasurer of the Primary Care Cardiovascular Society and a GP in Bishop Auckland, County Durham, said the whole health service had to ‘move up a gear' in response to this guidance.

‘The stroke guidance should be easy to implement, because it is obvious they should be admitted as an emergency, but organisationally it is harder to get an assessment for TIAs. Commissioners may have to consider walk-in clinics that GPs can send patients to,' he said.

The guidelines follow the release of the Government's stroke strategy in April, which made similar recommendations and promised £77 million of extra funding to boost stroke services.

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