Further progress needed in treating stroke

Results from Wales are still falling behind those from England, and are a major cause for concern. The audit, funded by the Healthcare Commission, was carried out on behalf of the Intercollegiate Stroke Group by the Royal College of Physicians’ Clinical Effectiveness and Evaluation Unit (CEEu), and covers 100% of eligible hospitals in England and Wales. As in 2005, results for each participating site are published on the RCP website which can be found atwww.rcplondon.ac

Headline results include the following:

• 62% of patients were admitted to a stroke unit at some point in their stay, compared to 46% in 2004. 54% spent over half their stay in a stroke unit (40% in 2004). This is a significant and welcome improvement, as now 91% of hospitals have a stroke unit (79% in 2004) but there is still a lack of capacity.

• Patients managed on stroke units have much better results than patients looked after in other settings. They are much more likely to have had their ability to swallow checked, to have started aspirin within 48 hours, been assessed by therapists within the recommended times, had rehabilitation goals documented and have a home visit performed before discharge.

• 76% of patients with minor stroke in hospital for less than two days are not being managed on specialist units. These patients have a high risk of having another stroke and should receive expert care and investigation.