Stroke care after discharge varies widely across UK, audit finds

BMJ 2015; 350 doi: (Published 08 June 2015) Cite this as: BMJ 2015;350:h3058
  1. Jacqui Wise
  1. 1London

The care provided to stroke patients once they have left hospital shows widespread variation across England, Northern Ireland, and Wales, an audit has found.1

The inaugural audit by the Sentinel Stroke National Audit Programme concluded that too many areas fail to commission comprehensive post-acute stroke care. It also raised concern that care home residents may be denied access to stroke rehabilitation services in some areas.

The organisational audit, led by the Royal College of Physicians, used information provided by commissioners about what services are provided and the extent of co-commissioning with other areas or with social services. Participation was very high: 222 of 223 commissioners and health boards provided data. A second report, expected by the end of the year, will give more detail on waiting times for treatment and its duration.

Around half (120) of the participating organisations are commissioning a six month post-stroke assessment for all patients, as recommended in the National Stroke Strategy.2 The audit found that 81% of organisations are commissioning early supported discharge, 92% being stroke specific.

Joint health and social care commissioning for post-acute stroke services occurs in only 37% of areas, the audit found. Also, one in four commissioning bodies does not have an allocated lead for stroke services, and only 56% have a commissioning group for stroke or similar.

The audit said it was reassuring that the majority (78%) of services commissioned for post-acute stroke care are stroke specific. But it added that care home residents are disadvantaged because only one third of commissioned services provide treatment to people living in care homes.

Geoffrey Cloud, associate director for stroke at the Royal College of Physicians, said, “Stroke mortality has almost halved in the last decade within the NHS and people are spending less time in hospital recovering from their stroke. There has never been a more important time than now to look systematically at what stroke care people receive when they leave hospital.”


Cite this as: BMJ 2015;350:h3058


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