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Improvement on stroke care still needed, says watchdog

By Nigel Praities

Stroke care has improved but patients are being delayed in hospital and are not receiving adequate follow-up care, according to a report from the National Audit Office.

The report, published today, says despite nearly £60m additional investment in stroke services the NHS still fails to treat patients promptly enough and provide adequate follow-up care.

It calls for a review of QOF targets to prevent stroke and for PCTs to ensure patients are given adequate information so that they can prevent a future stroke.

The NAO highlights ‘measurable improvements' in acute care since the National Stroke Strategy was launched by the Government in 2007, praising the Government's 'Act F.A.S.T.' advertising campaign and the fact that most hospitals in England now have a specialist stroke unit.

But it found that only 17% of stroke patients were in specialist care within four hours of their arrival at hospital in 2008. NICE guidelines on stroke recommend immediate admission to a specialist stroke unit.

The review also found 30% of patients were not given an appointment with a specialist within six weeks of discharge from hospital and only 24% of stroke patients were discharged on warfarin, despite NICE guidance stipulating they should be.

The report criticises the disparity between NICE targets for stroke prevention and the QOF, saying now NICE had responsibility for the QOF, it should review targets for blood pressure and cholesterol to see if they should match the targets in the institute's own guidelines.

Mr Amyas Morse, head of the National Audit Office, said: ‘Care for people who have had a stroke has significantly improved since we reported in 2005. The publication and early implementation of the stroke strategy have begun to make a real difference and have helped to put in place the right mechanisms to bring about these improvements.'

‘There is still work to be done though: the poorer performers must be dragged up to the same standard as the best, so that the gains that have been made are sustained and value for money improved further.'

Hospitals are not acting quickly enough to admit stroke patients to specialist clinics