Scotland urgently needs a long-term plan for stroke care to avoid a ‘crisis’, a leading charity has warned.
New official figures released by Public Health Scotland show that compliance with the Stroke Care Bundle, support that aims to decrease deaths, was 64 per cent in 2019 across the NHS.
This is an increase from 2018, when 59 per cent met Stoke Care Bundle targets. No health board in Scotland met the 80 per cent target.
The bundle puts targets on hospitals, including that 90 per cent of stroke patients are admitted to a stroke unit within one day of admission, should receive a swallow assessment within four hours of admission, a brain scan within 12 hours of admission and aspirin should be initiated by the day after hospital admission for stroke for 95 per cent of appropriate stroke cases.
Charity Chest Heart and Stroke Scotland (CHSS) is urging the Scottish government to address this.
The findings indicate that targets were not being met before the Covid-19 pandemic, which is a concern, says Lawrence Cowan, campaigns director at CHSS.
“With greater stress on health services because of the pandemic and the more complex needs of people in the community, if the Scottish government doesn’t intervene with a plan and package of support for stroke care, this could turn into a stroke care crisis,” he says.
“If we’re struggling to meet key care standards before the pandemic, stresses on the system now are increased, and will reflect in next year’s statistics.”
Demand for CHSS’s services has doubled over the pandemic, and it is seeing people with more complex needs needing more intense care. This, Cowan says, is partly because of pressures on the NHS meaning more patients were discharged earlier into the community.
“People are then at home, needing a lot of support to process what’s happened to them. There’s an emotional impact of surviving a life-changing event,” Cowan says.
The charity, which offers hospital-to-home support for stroke survivors, is also seeing more people struggle with the physical aspects of recovery as face-to-face services were taken away at the beginning of the lockdown in March.
The Scottish government needs a package of support to meet increasing complexities and ease pressure on the health system, Cowan says – including investment in community services.
“The more likely you invest in community services like ours, the more likely it is you’ll reduce pressure on the NHS. We see this as a whole set of community services delivered by the NHS and charities like ours – if we get that right and properly support people during the pandemic, it will reduce pressure on the NHS and avoid a stroke care crisis.”
Charities working in the sector also need support because of the loss of fundraising over the pandemic, Cowan adds. CHSS have seen its income half, while demand for its services have doubled.
“If we miss investing in the whole system, and instead focus on where the problem immediately lies, without looking at the underlying causes and symptoms, we’ll end up with self-perpetuation.”
While providing quality stroke care is more challenging pre-covid, Cowan says people need help now more than ever before.
“People feel under strain at home when they’re trying to recover from a life-changing event. The pandemic has wide-ranging impacts on stroke survivors’ ability to recover, and there’s been an impact on carers.
“Every element of a patient’s life has been impacted by Covid, and if we don’t meet those needs now, it could impact their recovery over the longer term.”
A Scottish government spokesperson said: “Our Stroke Improvement Plan is helping to deliver important improvements in prevention, treatment and care, with mortality rates decreasing by 35.2 per cent over the last 10 years.
“We want to build on this progress and ensure people who have had a stroke get access to the best possible care as quickly as possible. We are focused on providing that care in acute settings as well as helping people’s long-term recovery in their own communities.
“The Scottish Government expects NHS boards to appropriately plan and deliver high-quality, safe, effective services and to regularly review services to maintain high level of quality and safety that people in Scotland expect and deserve.”
