Nearly HALF of NHS hospitals are low of stroke specialists

Thousands of lives ‘are at risk’ from strokes because nearly HALF of NHS hospitals don’t have enough specialist consultants, charity warns

• Stroke consultants positions are at a ‘worryingly low level’, a report warns
• A lack of consultants means decisions may not be made quickly
• Data also shows almost every hospital is also lacking psychologists
• Three quarters of stroke survivors suffer poor mental health and need support
• Stroke is the fourth biggest killer and leading cause of disability in the UK 

Thousands of lives are potentially at risk because half of NHS hospitals are running low of specialist stroke doctors, experts warn. 

Stroke – caused by a block of blood flow to the brain, normally through a blood clot – is the fourth biggest killer in the UK. 

But stroke consultant positions are at a ‘worryingly low level’, a scathing report from a leading charity has warned.

The Stroke Association said Britain is ‘hurtling’ towards a major stroke crisis, unless the NHS can recruit specialist medics.

A lack of specialists on the ward means decisions may not be made quickly enough. Brain scans must be assessed by stroke consultants who also decide what urgent care is needed.

Data analysed by the charity shows there is a large variation in access to the services that stroke patients need across England, Wales and Northern Ireland. 

Ninety-three per cent of NHS hospitals do not employ enough clinical psychologists to support patients following their traumatic ordeal. 

Three quarters of stroke survivors battle depression, anxiety, lack of confidence or mood swings, charities say. 

Thousands of lives are potentially at risk because nearly half of NHS hospitals are running low of specialist stroke consultants (stock photo)

Stroke Association chief executive Juliet Bouverie said: ‘Unless these workforce issues are urgently addressed, we are hurtling our way to a major stroke crisis in the next few years.  

‘The lack of senior doctors and also of trainees to fill these gaps is worsening and is a ticking time-bomb for an already stretched health service. 

‘The stroke skills gap threatens the sustainability of many services and puts increased pressure on local hospitals. 

‘There are over 100,000 strokes every year in the UK and this is estimated to rise to 150,000 over the next five years which will increase the pressure on stroke wards further.’

HOW DID EACH REGION COMPARE? 

The data looked at 169 hospitals in England, Wales and Northern Ireland, 81 of which had at least one stroke consultant vacancy.  

The number of hospitals that had a vacancy is as follows: 

London: 8/22 hospitals

East Midlands: 6/7 hospitals

East of England: 6/15 hospitals

West Midlands: 8/15 hospitals

Greater Manchester and Eastern Cheshire: 3/9 hospitals

North West Coast: 8/13 hospitals

North of England: 6/12 hospitals

Yorkshire and the Humber: 7/14 hospitals

South East: 10/15 hospitals

South West: 7/14 hospitals

Thames Valley: 1/5 hospitals

Wessex: 4/7 hospitals

Wales: 2/12 hospitals

Northern Ireland: 5/8 hospitals

Islands: 0/1 hospitals

The charity highlighted the new findings from the Sentinel Stroke National Audit Programme’s (SSNAP) Acute Organisational Audit Report.

According to these figures, 48 per cent of all hospitals – 81 of 169 hospitals –  have had vacant stroke consultant posts unfilled for at least one year.

It’s an increase on the 40 per cent in 2016 and 26 per cent in 2014. Data suggests there is a similar outlook in Scotland, the BBC reports. 

In London, eight of 22 trusts had at least one vacant position. Almost every trust in East Midlands – seven out of eight – had a vacancy.

Half of hospitals in North of England, Yorkshire and Humber, South West, Wessex and Northern Ireland reported at least one unfilled position. 

‘Gaping holes’ in staffing levels of experienced stroke professionals may jeopardize the recovery of patients, the Stroke Association says. 

Effective treatment of stroke as soon as possible can prevent long-term disability and save lives. 

Specialist doctors are needed to look over brain scans and implement the best treatment as soon as possible to prevent death and lasting muscle weakness, paralysis, stiffness, or changes in sensation. 

Ms Bouverie said: ‘It really matters. Time loss is brain loss.’

Stroke does not just have the potential to affect cognitive function, but the trauma and suddenness of a stroke can also be really difficult to deal with.

One in six people have suicidal thoughts after their stroke, research by the charity has previously found.  

Psychological support is vital for those that need it straight after a stroke as well as during recoveries – but only seven per cent of hospitals are reaching recommended staffing levels. 

Overall, just 16 per cent of hospitals achieved seven out of ten criteria, which include the presence of a stroke specialist and enough nurses at weekends.

Ms Bouverie said: ‘Stroke happens in the brain, the control centre for who we are and what we can do, which is why it is vital that hospitals have the right amount of the right staff ready to support both the mental health and physical effects your stroke can have on you.

‘We are deeply concerned by the rate at which highly qualified stroke doctors are leaving the profession and the slow uptake of stroke medicine by new doctors. 

‘The highest standards of stroke treatment and rehabilitation must be available to all. The progress in stroke treatment and care over the past 10 years run the risk of being wasted without experienced doctors to deliver world class stroke services.’

Professor Tom Robinson, outgoing president of the British Association of Stroke Physicians, said: ‘We must urgently address the lack of professional stroke staff to ensure that patients have access to the best treatment as quickly as possible.’ 

WHAT IS A STROKE AND HOW IS IT CAUSED BY A BLOOD CLOT? 

There are two kinds of stroke.

Ischemic stroke – which accounts for 80 percent of strokes – occurs when there is a blockage in a blood vessel.

It’s caused by a blockage in an artery that supplies blood and oxygen to the brain, leading to damage or death of brain cells. If circulation isn’t restored quickly, brain damage can be permanent.

A blood clot blocks the artery, or fatty buildup called plaque. This blockage can appear at the neck or in the skull but start in the heart and travel through arteries.

Haemorrhagic stroke, which is more rare, occurs when a blood vessel bursts, flooding part of the brain with too much blood while depriving other areas of adequate blood supply.

It can be the result of an AVM, or arteriovenous malformation (an abnormal cluster of blood vessels), in the brain.

RISK FACTORS

Age, high blood pressure, smoking, obesity, sedentary lifestyle, diabetes, atrial fibrillation, family history, and history of a previous stroke or TIA are all risk factors for having a stroke.

SYMPTOMS OF A STROKE

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding 
• Sudden trouble seeing or blurred vision in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination 
• Sudden severe headache with no known cause 

OUTCOMES

Of the roughly three out of four people who survive a stroke, many will have life-long disabilities.

This includes difficulty walking, communicating, eating, and completing everyday tasks or chores. 

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