Pembury must improve stroke patient care

    Doctor

    Here is the latest in a series of monthly columns written exclusively for this newspaper by Tunbridge Wells MP Greg Clark, in which he offers his own unedited thoughts and opinions.

    Around the world on Saturday October 29, hospitals, medical practices, charities and community groups join forces for World Stroke Day to help drive improvements to the treatment of one of the most common medical emergencies.

    Stroke is one of the largest causes of death in England and Britain’s leading cause of adult disability.

    Improving care for people who suffer a stroke has been one of the causes I have campaigned for since I was first elected to Parliament. Serving on the Public Accounts Committee of the House of Commons, I joined an investigation into why more people died and were left disabled by strokes in Britain compared to other countries.

    I was shocked to discover that more people suffering a stroke in Britain died or were left significantly disabled than in other countries, such as Australia, Sweden, Germany and Canada.

    In Australia, for example, for every 100 people suffering a stroke nearly 13 died – whereas in Britain nearly 30 died. And the rate of disability was much higher in Britain, too.

    The reason for the disparity, we discovered, was down to organisation. Indeed, the way other countries organised their stroke care cost much less than the British way, in which delays resulted in longer hospitalisation and rehabilitation.

    Speed is of the essence. The shorter the time between the stroke and treatment, the greater the chance of reducing damage to brain tissue. The medical saying goes ‘time lost is brain lost’.

    A stroke is always an emergency. Best practice is that everyone who has a stroke should have a brain scan within one hour of being admitted to hospital. If clot-busting drugs can be given within three hours, this will significantly reduce the risk of death and disability.

    By far the best organisation is to have specialist stroke units providing 24-hour treatment and care, rather than more, smaller units operating part-time or in generalist areas. Yet when the committee investigated the situation, only 22 per cent of stroke patients in England had a scan on the same day as their stroke, and most waited more than two days. Less than half of patients spent most of their time in a specialist unit.

    Thankfully, our Committee’s report led on to the development of the National Stroke Strategy in 2007. It set out a move to dedicated 24/7 Stroke Units and protocols for immediate scanning of suspected stroke patients across the NHS. But it was with great concern that I learned in 2014 that in Tunbridge Wells only 20 per cent of stroke patients were being scanned within one hour of arrival, only 20 per cent were admitted within four hours, and over 30 per cent of eligible patients were not being given thrombolysis – the specialist treatment required.

    I pressed our local NHS to take action to improve this unacceptable situation. The latest performance figures show that the hospital has made some improvements, but there is still a long way to go.

    A Kent and Medway Stroke Review is now in the phase of engaging with stroke survivors to redesign the system. The final proposals are due to be published next year, and what I hope to see in those plans is a radical overhaul of the service with the opening of specialist stroke units operating 24 hours a day, 365 days a year – a system other countries have been following for well over a decade.

    One of my first campaigns in Parliament was to get the approval for the new hospital at Pembury to be built.

    It is a magnificent facility, staffed by dedicated staff and all of us have family and friends who have been helped by the team there.

    But transforming stroke care is one of a number of areas – including mental health care and dementia care – in which I believe it is important to secure further improvement.


    Greg Clark was elected to Parliament as a representative of Tunbridge Wells in 2005. The Conservative MP has since held a number of positions in Government and currently sits as a member of the Cabinet in his capacity as Secretary of State for Business, Energy and Industrial Strategy: www.gregclark.org