The results of the 2006 National Sentinel Audit for Stroke show that patients in Wales are more likely die from stroke, or if they survive will have higher levels of disability than in England or Northern Ireland.
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.
The late launch of a National Service Framework in Wales in 2006 appears to have handicapped the development of specialist stroke services in Wales, which need urgent attention. Only 45% of eligible hospitals in Wales (nine hopsitals) have a stroke unit, compared with 96% of eligible hospitals in England. Only 3 sites (15%) have acute stroke unit provision. Given the evidence for the benefits of stroke units, the very low rate of stroke unit provision and admission is unacceptable.
Only 28% of patients in Wales were treated in a stroke unit during their stay compared to 64% in England and 73% in Northern Ireland
Only 22% of patients in Wales spent more than half their time on a stroke unit (56% England, 60% NI)
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
Only 38% of patients had brain imaging to confirm their diagnosis within 24 hours of the onset of symptoms, a figure similar to England (43%) and NI (40%). This figure is unacceptably low and must be improved. Patients need a brain scan to determine if it is appropriate to prescribe aspirin ? if given within 48 hours of the stroke this can save lives and reduce disability
The percentage of patients screened for swallowing disorders in Wales was 55% compared to 67% in England and 62% in Northern Ireland
Physiotherapy assessment within the first 72 hours of admission was carried out in 54% of patients in Wales, compared to 72% in England and 74% in Northern Ireland