By investing in the right treatment and after-care for stroke survivors, we could improve patient outcomes and save the NHS money
4 min read
To begin with, an admission: prior to summer 2019 my knowledge of stroke, like many, was somewhat limited.
It was then that my wife, Ann-Louise, suffered a severe stroke, from which she is still recovering. Needless to say, the learning curve our family has been on since has been steep and extremely challenging, but it’s one that, unfortunately, isn’t uncommon.
After all, stroke strikes every five minutes in the UK. It remains the nation’s fourth biggest killer, the largest cause of adult disability (with two-thirds of stroke victims leaving hospital with some form of lasting impairment), and costs the UK economy an estimated £26bn a year.
Before reading any further it’s worth letting those figures sink in, for once you have, it swiftly becomes apparent how remarkably little public understanding there is of stroke, and how woefully inadequate the attention afforded to it is.
In very simple terms, stroke is a sudden brain attack that can leave an otherwise healthy individual unable to walk or talk, cruelly stealing from them some of life’s simplest pleasures – in my wife’s case, an opera singer, her ability to perform. Unsurprisingly, it’s frequently followed by bouts of depression and anxiety, prolonged loneliness, as well as increased comorbidity, including risk of dementia.
Stroke is the largest cause of adult disability in the UK
While we have taken significant strides forward in the treatment of stroke, with thankfully far more people now able to survive it, there can be no doubt, were it to be resourced comparatively with other serious illnesses or long-term conditions, so much more could be achieved. The availability of mechanical thrombectomy, a cost-effective, gamechanging procedure, is a case in point.
Rarely does a silver bullet exist in medicine, but thrombectomy arguably comes as close as you can get to one. By using a stent retriever to remove clots and recover blood flow to the brain, it dramatically reduces the severity of disability caused by stroke and, what’s more, saves the NHS on average £47,000 per patient.
If such a treatment existed for cancer, for example, or Alzheimer’s, then there would quite rightly be a public outcry that we hadn’t invested heavily in it. And yet, though that technology is at our disposal, the UK has some of the lowest rates of thrombectomy in Europe – just 2.4 per cent (against an NHS target of 10 per cent). By comparison, Germany’s rate currently stands at eight per cent, and in other European countries, it’s as high as 22 per cent. Rates of thrombolysis, another stroke treatment, have stagnated since 2013.
But it’s in the weeks, months and years after a stroke takes place that we’re really failing the UK’s 1.3 million stroke survivors. Figures published last month as part of the Post-Acute Organisational Audit (which only takes place every six years) show that only one third of community rehab teams meet treatment time targets, while less than 50 per cent of inpatient services have the recommended levels of any of the core disciplines.
That means things like physiotherapy and speech and language support are all too often falling by the wayside. It’s no wonder that 45 per cent of stroke survivors report feeling “abandoned” after leaving hospital.
Ann-Louise continues to fight bravely and determinedly to come back from her stroke. As so many others have shown, it can be done, but it’s a long and hard road that requires not only immeasurable courage and patience, but also consistent professional support. The teams that have worked with her have been exemplary in their dedication and care, and I cannot thank them enough. But the reality is, they are massively overstretched and struggling to keep up.
Stroke survivors have been underserved for too long (amazingly, there isn’t even a dedicated official tasked with overseeing stroke in the Department of Health and Social Care). Many victims have literally been robbed of their voice, which is why it’s so important that all of us, together, speak for them.
Sir Bob Neill is the Conservative MP for Bromley and Chislehurst.
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