Just over a third of stroke patients are still being admitted to non-specialist units, four years after a Department of Health strategy ordered trusts to ensure everyone received the best care.
The finding – from the Stroke Improvement National Audit Programme – comes despite NICE guidance saying that all patients with suspected stroke ‘should be admitted directly to a specialist acute stroke unit’ following initial assessment.
The audit found some improvements in stroke care, with 8% of patients receiving thrombolysis following a stroke, up from only 1% in the 2008 audit.
It also reported ‘considerable improvement’ in the number of patients receiving brain scans within 24 hours. In the 2006 audit only 42% of patients were scanned within 24 hours, but this had risen to 70% in 2010.
But the audit also found 34% of patients were directly admitted to a non-specialist unit despite clear evidence of benefit from stroke unit care.
The report said: ‘It is a concern that all hospitals still admit a proportion of patients to non-specialist medical admissions or diagnostic units.’
‘All patients, not just those triaged for thrombolysis, need immediate stroke unit care. Trusts who are not routinely admitting patients directly to stroke units need to reconsider their pathways of care.’
The audit was commissioned by the Healthcare Quality Improvement Partnership and run by the Royal College of Physicians’ Stroke Programme.
Professor Tony Rudd, chair of the Intercollegiate Stroke Working Party and director of the RCP stroke programme, said: ‘Acute stroke services are improving in England, albeit from a low base.’
‘We will be working hard to increase participation as I believe that publicly available data comparing each hospital against their peers is a very powerful tool to improve the quality of care.’