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Postcode Lottery In Stroke Treatment Needs To Change

Monday 14 March 2005

A leading health charity has welcomed a study of stroke care by the Royal College of Physicians – but says a “postcode lottery” still exists in Northern Ireland.

A leading health charity has welcomed a study of stroke care by the Royal College of Physicians – but says a “postcode lottery” still exists in Northern Ireland.

The NI Chest, Heart and Stroke Association points to the fact that everyone treated for stroke in the Erne Hospital in Enniskillen can expect to be admitted to a specialist stroke unit, while the figure is zero in the Causeway Trust area because no such unit exists.

The RCP Sentinel Audit also identified substantial variations in 11 other benchmark standards for stroke treatment. While almost all stroke patients had their mental well-being assessed on discharge from hospital in Craigavon and in the Royal group in Belfast, the figure fell to zero in the Down Lisburn Trust area.

The NICHSA Chief Executive, Andrew Dougal, said: “While Northern Ireland still shows a slightly better picture of overall stroke care than England, discrepancies still exist, and stroke survivors are being failed in some areas of treatment. Taking an average over the 12 key indicators, the Erne Hospital, with 90%, is by far the best place to be treated, while the Mater Hospital in Belfast trails well behind on 32% compliance with the key standards, although we expect its performance to improve in the near future because it has recently opened a stroke unit.
“The huge variations in care need to change if everyone in Northern Ireland is to have an equal chance of recovery after stroke.”

The Association expressed concern about the poor assessment of patient mood and the fact that it has fallen since a previous audit in 2001. It is estimated that up to half of stroke survivors suffer from depression, and this affects not just the individual, but the whole family. The shortcomings in psychological care result in a needlessly poor quality of life which needs to be addressed urgently, according to the charity.

Said Mr Dougal: “The clear message from this study is that if the will exists, stroke care can be transformed. Congratulations are due to Dr Jim Kelly and his team at the Erne Hospital for the great strides they have taken in this area. It is disappointing, however, that several areas, including Coleraine and Downpatrick, are still without stroke units, which have been shown greatly to assist patient recovery.”

Mr Dougal added: “It is important to note that the Sentinel Audit addresses treatment only in acute hospitals and doesn’t monitor standards of care in the community, upon which so many people rely since almost one third of stroke patients will have a residual disability upon discharge from hospital. The NI Chest Heart and Stroke Association will continue to work with Trusts, Boards and the Department of Health to support the development of services for stroke.”

Ends

58% of stroke clients in Northern Ireland are admitted to a stroke unit while only 47% of stroke clients are admitted to a stroke unit in England.

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