30.11.16
Improvements in stroke services at risk due to increasing staff shortages
Hospital stroke services are suffering from an increased shortage in qualified staff, according to the third annual report from the Sentinel Stroke National Audit Programme (SSNAP).
The proportion of sites reporting an unfilled stroke consultant position increased from 26% in 2014 to 40% in 2016.
The Royal College of Physicians (RCP), which conducted the audit, warned that the role of consultants will be more important as new treatments are developed and acute care becomes more complex.
The audit found that the quality of services has improved, but the RCP warned that this could be reversed by a continuing shortage of staff.
All hospitals now have a dedicated stroke unit, and 81% have specialist early supported discharge, meaning that patients can return home sooner and receive specialist post-acute care.
The report found that the percentage of patients receiving a brain scan within an hour has risen from 42% to 48% since the audit began, and the median door to needle time for thrombolysis has reduced from 58 minutes to 55 minutes.
The audit also found that just 6% of hospitals meet the target of one whole time equivalent clinical psychologist for every 30 stroke unit beds, and only 20% meet the standard for weekend nurse staffing levels.
There was also a mixed picture on seven-day access to services, with 40% of hospitals offering physiotherapy throughout the week. But just 31% offer physiotherapy and only 6% offer speech and language therapy at the weekend.
Professor Pippa Tyrrell, associate director for stroke for the RCP’s Clinical Quality Improvement Department, said: “Stroke care has improved beyond recognition in the last 20 years.
“Patients are almost routinely being admitted to specialist stroke units where, in general, they receive high quality care, they stay in hospital for a very much shorter period of time, and are often discharged to early supported discharge (ESD) services where rehabilitation continues at home.”
However, Prof Tyrrell noted that there is still a marked variation of services and patient outcomes across the UK.
“Some patients cannot access acute stroke units rapidly, and are therefore denied treatment such as thrombolysis or thrombectomy,” she said. “Seven-day working is improving, but access to speech and language therapy at weekends remains extremely low.”
A recent NHS Providers’ report found that many trust chairs and chief executives believe staff shortages are now a more pressing problem than funding pressures.
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