Stroke Services

Jim Shannon Excerpts

Tuesday 5th December 2017 Commons Chamber

[Sir David Amess]

I very much welcome that news. I think that the two of us will look forward to meeting the Stroke Association and working with it to enhance the already excellent facilities at Southend Hospital.

The costs of stroke to the NHS and social care are about £1.7 billion a year, which is a huge amount. If I may be biased for a moment, let me say to the Minister that since 2013, the Government whom I support have contributed to significant advances in the treatment of stroke victims all over the country. The percentage of patients scanned within one hour of arrival in hospital has risen from 42% in 2013 to 51% last year, and the figure for those scanned within 12 hours has increased from 85% to 94%. I think the whole House will welcome that improvement, and I am grateful to Members on both sides of the House who are in the Chamber to listen to this Adjournment debate. I hope that their constituents will recognise the fact that they have stayed here.

[Jim Shannon (Strangford) (DUP)]

I sought the hon. Gentleman’s permission to intervene before this debate, Madam Deputy Speaker.

Right across the UK there are many problems in relation to stroke services. Some 4,000 people in Northern Ireland have had a stroke in the past year, and 36,000 people in Northern Ireland are living with the effects of a stroke. What consideration has the hon. Gentleman given to people having a normal life after stroke through the provision of rehabilitation, and of occupational and cognitive therapies, and through the way in which the NHS handles aftercare, especially for the growing number of younger people who have strokes? This is not just about people in their 70s; it is sometimes about those in their 30s, 40s and 50s.

[Sir David Amess]

If I did not know better, I would have assumed that the hon. Gentleman had read my speech, because I was just about to say that in the past three years there has been a rise in compliance with standards for physiotherapy from 53% to 79%, and from 24% to 47% for speech and language therapy. I know that similar progress has been made in Scotland. With all that in mind, it is essential that the NHS continues to lead from the front. We must utilise some of the newest technologies to improve the effectiveness of stroke treatment, to allow patients to live fuller lives, and to decrease the burden of ill health after someone has suffered a stroke.

Two out of three stroke survivors currently leave hospital with a long-term disability at a cost of £1.7 billion, as I said. The provision of healthcare to people who have had a stroke accounts for approximately 3% to 5% of all healthcare expenditure, which is a vast amount. The cost of stroke treatment will rise to £43 billion in 2025 and £75 billion in 2035. If I remember rightly, I think the husband of the hon. Member for North Down (Lady Hermon) suffered strokes during his illness.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

What a pleasure it is to see you, Madam Deputy Speaker; it has been a while. I knew that my hon. Friend the Member for Southend West (Sir David Amess) would get in a mention of Southend becoming a city. I was only disappointed that it did not happen earlier in his speech, but he managed it in the very last line. I will show great diplomacy and leave that matter to the Ministers responsible. I congratulate him on securing another Adjournment debate—we have done this before—which is on stroke services this time. As ever, he set out his case brilliantly and with such passion. He gives newer parliamentarians a real lesson in how to handle debates in this House.

As my hon. Friend said and as so many of us know, stroke is a devastating disease for patients and their families. He is right that there are currently 1.2 million stroke survivors in the UK, with more than 1,350 in my hon. Friend’s constituency alone. The hon. Member for Strangford (Jim Shannon), who is in his place as always at these debates, is absolutely right that stroke is predominantly a condition that affects older people. But it does affect younger people. I have met people of my age and younger who have been affected by stroke. Obviously, it is clinically debilitating, but it also comes as a great shock to their friends and families, who are taken aback by this happening to young people.

So many NHS staff work in multidisciplinary teams on stroke, and I pay tribute to them. There are nurses, consultants and speech and language therapists—the speechies, one of whom I am married to, so I will get brownie points for this—as well as physios, occupational therapists and specialist nurses, who all do so much when somebody suffers a stroke. The Stroke Association, which has already been mentioned, is an absolutely first-rate charity and a real partner for the Government. I also commend my hon. Friend the Member for Southend West for his strong work in driving improvements to stroke services both nationally and within his constituency. I know that he has taken a long interest in health matters, including stroke, as an MP. I reiterate his comments about the high-quality service provided by Southend stroke unit—more on that in a moment.

My hon. Friend will no doubt agree—he said this of course—that, in general, stroke services across the country are performing really well. Let me just reiterate some of the figures. Thirty-day mortality has dropped from 30% in 1998 to just over 13% in 2015-16—a huge improvement. The percentage of patients scanned within one hour of arriving at hospital, which is so critical, has increased from 42% in 2013-14 to over 51% in just three years, and the percentage scanned within 12 hours has increased from 85% to 94% in the same period.

There are many public health campaigns that we remember throughout the years, but the Act FAST campaign that public health campaigners and the Stroke Association have done is something we see and do not forget, and that, of course, was the intention.

Excellent progress has been made in the treatment of stroke over recent years. It is important that this programme continues and that the gains are built on, especially given the demographic changes we know are coming down the track with our much talked off and much publicised obesity challenge and our ageing population. That is why we published the cardiovascular disease outcomes strategy in 2013.

There is ongoing work in virtually all parts of the country to organise acute stroke care to ensure that all stroke patients have access to high-quality specialist care, regardless of where they live or what time of day or week they have their event. Although the national stroke strategy comes to an end shortly, as my hon. Friend said, NHS England continues to lead an effective programme of work on prevention and treatment. We are continuing to work closely together to improve acute treatment through the centralisation of care in centres that can provide the highest level of care and treatment at all times of the day and night.

Decisions on whether the strategy should be renewed are, of course, a matter for NHS England, but in liaison with Ministers. My understanding is that NHS England does not have current plans to renew it in the same form, but it is a subject that I, as the relatively new Minister, encouraged, of course, by my hon. Friend’s debate, plan to discuss with NHS England early in the new year. I would welcome my hon. Friend’s involvement —and that of other Members—if he wishes to feed into that.

[Jim Shannon]

I thank the Minister for his comprehensive response. One thing that is sometimes overlooked is research and development—the work that is done by universities in conjunction with health groups to try to find better ways of caring for people with strokes. Does he have any information on how critical that is to the whole care package that is given to those who have had strokes?

[Steve Brine]

I echo the hon. Gentleman’s sentiment that that work is critical. I mentioned the Act FAST campaign, which was a heavily evidenced public health campaign showing that the quicker we act after the event, the better the outcome, so he is absolutely right to highlight that issue. However, I am conscious of time, so I am going to press on.

My hon. Friend rightly spoke about mechanical thrombectomy, which he called a game-changer, and he is absolutely right. To continue and build on our stroke service success and to address the costs associated with stroke in England, which was one of my hon. Friend’s first asks, it is imperative that we keep identifying and developing innovative treatments and cutting-edge procedures.

In mechanical thrombectomy, or MT as we shall know it, we have an innovation that we believe can significantly improve patient outcomes, and my hon. Friend spoke about that. In April this year, NHS England announced that it will commission mechanical thrombectomy so that it can become more widely available for patients who have certain types of acute ischaemic stroke, which is a severe form of the condition. My understanding is that work by NHS England is now under way to assess the readiness of 24 neuroscience centres across the country. It is expected that the treatment will start to be phased in later this year and early next year, with an estimated 1,000 patients set to benefit across the first year of introduction. Overall, this will benefit an estimated 8,000 stroke patients a year and save millions of pounds in long-term health and social care costs—my hon. Friend was absolutely right to point out the rising costs to NHS England around this condition.

As the clinical director for stroke at NHS England has said, we are committed to fast-tracking new and effective treatments that will deliver long-term benefits for patients. For me, this treatment is just one example of many that we believe have the potential to tangibly improve patient care and to address rising costs.