An official report shows many hospitals are still not meeting important care standards for stroke patients – more than 15 years after the Scottish Government made the condition a priority.
Stroke is the third most common cause of death in Scotland and 10,233 people were diagnosed with a stroke in hospitals last year.
Just 34 per cent of stroke patients for whom clot-busting drugs are appropriate receive them within an hour of reaching hospital, even though evidence shows they reduce the number of brain cells damaged.
Only 58 per cent of patients last year were given the four other key treatments which include being admitted to a stroke unit and receiving a brain scan within a day of reaching hospital.
NHS Greater Glasgow and Clyde, the country’s biggest health board, had one of the worst records in the country for meeting all four criteria. NHS Orkney was the only area to have a smaller proportion of patients treated in line with the four ” standards,” and it did not have an operational CT scanner on the island.
The care of patients has improved – the proportion treated in line with all four requirements of the care bundle was 48 per cent in 2012, a rise of 10 percentage points in a year.
Andrea Cail, Scotland director of the Stroke Association, said lives had been saved by the quality drive, but added: “There are still significant variations in treatment and care depending on where we live, which is unacceptable.”
The Scottish Stroke Care Audit, which was published recently, revealed that in 2013, 12 out of 31 hospitals managed to admit 90 per cent of stroke patients to a stroke unit within a day and 13 ensured 90 per cent of patients were scanned within 24 hours.
Both measures are known to improve the chances of survival and reduce the risk of disability.
Professor Martin Dennis, stroke specialist for NHS Lothian said it could be difficult to ensure patients were looked after in the right place when hospitals were very busy. “Organising a scan in time”, he said, “could also be affected by the time a patient arrives in hospital, as not all centres have the staff required around the clock.”
Delays in scanning patients mean that aspirin and a clot-busting drug are not given as quickly as necessary.
Professor Dennis warned this was a difficult goal, saying it relied on ambulance crews to alert hospitals to the pending arrival of stroke victims and accident and emergency departments to diagnose strokes very swiftly.
The Stroke Association said there were many examples of good practice it would like to see replicated in other hospitals across Scotland. Given the pressure on NHS funding in the years ahead, it will be very challenging to those who are striving hard to meet an optimum package of care.
A Scottish Government spokeswoman said there had been a 5.8 per cent drop in the number of deaths from strokes in Scotland since 2012, but there was still more to be done.