The Big Picture: Costs cut at a stroke

Stroke is a leading cause of severe adult disability and is the UK’s third biggest killer. It costs the economy £7bn a year, yet stroke services are in a woeful state.

The recent publication of the consultation document for the National Stroke Strategy in England is a significant step, recognising the urgent need to transform stroke services across the whole care pathway.

For too long improvements in stroke care have been slow, piecemeal and patchy. However, the Stroke Strategy has the potential to transform the way stroke is treated by health and social care services. If implemented it could achieve dramatic reductions in mortality rates, improve levels of disability, reduce the overall cost of stroke care and improve the quality of life for the tens of thousands of people who have their lives shattered every year.

Although it cannot be implemented on a cost-neutral basis, getting emergency and acute care right, along with providing good rehabilitation services, will deliver savings in the longer term.

Increasing the recruitment and training of specialist stroke health professionals is vital in delivering quality acute care. A stroke unit is a hospital ward staffed by a specialist, multi-disciplinary team (stroke clinicians, consultant stroke nurses, physiotherapists, speech and language therapists and occupational therapists). Admittance on to such a ward reduces mortality by up to 25%. Initial investment to increase the capacity of acute stroke units, ensuring immediate access and enabling people to spend most of their hospital stay within one, could save 500 lives a year and save the NHS £82m.

A better co-ordinated support service on leaving hospital is also needed. Stroke survivors need to be treated as individuals with their care determined by their needs rather than by what resources are available.

In order for the Stroke Strategy to be a success the quantity and quality of these services must be measured. Commissioners and service providers must be required to follow the recommendations with quality standards or benchmarks in place.

However, underpinning all of this is the public’s low awareness of stroke. If the government is serious about putting stroke care on the same footing as cancer and heart disease care, a national campaign to raise the public’s awareness of the risks, the symptoms and prevention of stroke is paramount.

Jon Barrick is chief executive of The Stroke Association

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