Stroke: Aftercare

Justin Madders Excerpts

Wednesday 21st April 2021 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Sir Edward. I thank the hon. Member for Bromley and Chislehurst (Sir Robert Neill) for securing the debate and for his detailed introduction. He highlighted that there is increased awareness of the symptoms of strokes, and that acute care has certainly been on an upwards trajectory. The point that he made so eloquently and so personally was that there is still a long way to go on aftercare. He spoke of courage, patience and consistent professional care being needed, and that is something that we all want to see. A number of hon. Members added their personal perspectives to the debate. I believe we always do better when we hear those perspectives.

We also heard a professional perspective, from my hon. Friend the Member for York Central (Rachael Maskell), who set out clearly the importance of specialist services. The question she asked about the future of those in the new structures was very important.

As we heard from various Members, strokes are very prevalent in this country—100,000 a year, or one every five minutes. We also know that two-thirds of stroke survivors leave hospital with a disability, and it is the fourth-largest cause of death in the UK. It is perplexing, as the hon. Member for Bromley and Chislehurst said, that it does not get more of our attention. As my hon. Friend the Member for Stockport (Navendu Mishra) said, it is also something of a mystery why the level of research funding is not as high as in other areas, even before the challenges of the pandemic that all voluntary fundraising organisations have faced.

Members will know that the national priority in the NHS long-term plan is the national stroke programme. It is intended to deliver better prevention, treatment and care. It is an ambitious programme, but if it is to succeed, it needs adequate funding. I hope the Minister will be able to set out briefly how that funding is being allocated and what progress is being made to meet the targets and aims set out in the plan. A recent report by the Stroke Association found that thousands of stroke survivors are being let down—in various ways, as we heard in the debate, but particularly in the current provision of post-stroke support and rehabilitation.

The most recent Sentinel Stroke National Audit Programme data for April 2019 to March 2020 shows that only 41% of patients received a recorded six-month post-stroke review, and just over a third of applicable patients received recommended levels of physiotherapy or occupational therapy. Less than a fifth received the recommended levels of speech and language therapy. As hon. Members put it in different ways, those figures are clearly not good enough. It needs to be emphasised that that poor record is from before the pandemic.

There were concerns before the pandemic about the shortage of specialist stroke consultants. Figures from Kings College London showed that almost half of hospitals had a shortage of specialist stroke consultants, with 48% of hospitals in England, Wales and Northern Ireland having at least one consultant vacancy in the previous 12 months or more. To pick up on the comment by the hon. Member for Beaconsfield (Joy Morrissey), the Stroke Association called on the Government and NHS England to make stroke medicine a more attractive proposition for junior doctors to specialise in, as well as the other specialities, and drew attention to the need for nurses and rehabilitation. Can the Minister update us on the number of consultant vacancies and say what steps are in place to introduce a plan to deliver the staffing levels that we so clearly need?

It is clear, from what everyone said, that we need to go further and faster to provide support for stroke survivors. Further investment is vital to ensure equitable access to services, avoid digital exclusion and improve health outcomes, to stop the kind of disparities that we have heard about. We must end the postcode lottery. It is so important that, no matter where you live, you get access to the same quality stroke support services, which are consistent with clinical guidelines. I hope the Minister will address the issues that Members have raised, and will set out what steps the Government intend to take to support more survivors of strokes.