National Stroke Strategy

Baroness Hodgson of Abinger Excerpts

Wednesday 18th November 2015 Lords Chamber

[Baroness Hodgson of Abinger (Con)]

My Lords, I, too, thank the noble Baroness for bringing forward this debate on a subject that is all too often overlooked. Strokes are devastating—they not only kill but cruelly maim. I have seen it personally. My father, aunt and mother-in-law all had strokes, so I know only too well about the terrible suffering and anguish that they cause. For some, it will be the end of their normal functioning lives, and even those who return to independent living often feel very vulnerable and suffer from depression.

Sadly, strokes are all too common. In the UK around 150,000 people suffer a stroke every year and, as we have heard, it is one of the largest causes of death. Even when not fatal, strokes can be desperately debilitating. My aunt changed from being an energetic, lively and outgoing person to being paralysed down one side and unable to speak. Even the mildest strokes tend to leave a mark.

Despite all that, there is a concerning lack of awareness of the symptoms, of the fact that, as we have heard, people of any age, including children, are susceptible, of the risk being greater among those of Asian or African origin, and, perhaps more importantly, of the fact that so-called mini-strokes are often a precursor to a much larger, more threatening stroke. It is estimated that if mini-strokes were properly identified and treated, around 10,000 major strokes could be prevented each year.

The noble Baroness, Lady Masham, highlighted very well how prevention is crucial, and many strokes are preventable. Much can be done to reduce the risks: diets, alcohol consumption and levels of exercise can all play a key role. Underlying conditions such as high blood pressure need controlling where possible. As we heard from my noble friend Lord Colwyn, less well known is the fact that atrial fibrillation can also be a serious risk factor.

The national stroke strategy, which was introduced in 2007 and to which many have alluded, has sought to develop and implement a comprehensive way of treating strokes. A further milestone was the set of quality standards focusing on clinical aspects developed in 2010. The National Audit Office has found that these have not only improved outcomes but saved the National Health Service an estimated £456 million since 2007. Where research leads to the development of new, improved treatments, it is important that these are adopted because, although they may be initially more expensive, in the long term they will improve lives and thus will equate to further financial savings.

More needs to be done so that people recognise when someone is having a stroke, as outcomes for stroke patients are intrinsically linked to response speed. The acronym FAST—face, arms, speech, time—is now the standard for identifying stroke symptoms. For strokes caused by clots, there is a maximum three-hour window to administer clot-busting drugs that will minimise damage. After that, it is too late. However, according to the Stroke Association, 60% of stroke emergency attendees at A&E arrive out of time. Rapid response from ambulance services is crucial, particularly in rural areas, where hospitals with the necessary expertise may be a long way away. Therefore, I ask the Minister whether monitoring is in place to ensure that all those who call for an ambulance in response to a stroke receive timely treatment, wherever they live.

I understand that nearly half of all stroke patients are scanned within an hour of reaching hospital, and 90% within 12 hours, but what about the 50% who are not scanned within one hour? How many of them could have been helped had they been? And are patients who need speech therapy or physiotherapy now given enough to enable them to make as good a recovery as possible? My aunt, some years ago, was offered speech therapy once a week when she actually needed it several times a day in short bursts if she was ever going to speak again. Consequently, she never did. Can I have an assurance from the Minister that older patients are given the best possible treatment? Anecdotally, I have heard of cases where those over the age of 75 are less bothered with. Much more attention also needs to be given to rehabilitation, as in a survey of stroke survivors 43% said that they wanted more therapy support once discharged home.

I, too, hope that the national stroke strategy will be revisited at the end of its current implementation period in 2017. Consultation with a wide range of healthcare professionals, stroke sufferers, carers and voluntary organisations will ensure that a revised strategy builds on the gains and adopts the latest research and treatment.

To conclude, I hope that the Government will ensure that stroke medicine across the country is adequately provided for and funded, including prevention measures, timely access to specialist services and necessary aftercare support and therapy, including psychological support. This, in turn, will mean better outcomes, healthier lives and a lower overall cost to the taxpayer.