6th August 2014 – Concentrating NHS stroke services in fewer, more specialised centres can save lives and cut the time patients need to stay in hospital, according to new research.
Stroke services were centralised in Greater Manchester and London in 2010. Before the changes in London, stroke patients were treated in one of 30 hospitals. After centralisation care was focused in 8 designated Hyper Acute Stroke Units where specialist teams are on hand 24 hours a day.
Research carried out by University College London found that the changes have cut the numbers of people dying after a stroke.
London experienced a significant drop in mortality among stroke patients after 3, 30 and 90 days from when they were admitted to hospital over and above that seen in the rest of England, indicating 168 fewer deaths after centralisation during the 21 month period following reconfiguration. This translates into 96 extra lives saved each year, the researchers say.
Although centralisation did not reduce death rates in Greater Manchester compared with the rest of England, the amount of time patients had to stay in hospital fell by an average of 2 days, equating to 8,842 fewer hospital days each year in the region.
In London, patients spent on average 1.4 fewer days in hospital under the new regime, equating to 12,766 fewer hospital days each year.
The study, published on the bmj.com, found that reductions in the death rate and length of hospital stay were largely seen among patients with ischaemic stroke, when a blood clot blocks an artery that carries blood to the brain.
The authors acknowledge that, while Hyper Acute Stroke Units are proving a success in metropolitan areas, they might be harder to configure in rural parts of the country where patients would have to travel further to get specialist treatment.
Commenting on the findings in a statement, Dr Shamim Quadir, research communications manager at the Stroke Association, says: "It has long been recognised that rapid, specialist medical treatment for stroke patients saves lives and reduces costs for the NHS. This latest research reveals that, without the centralised stroke service available to Londoners, around 96 people would have died following a stroke.
"It’s clear that access to Hyper Acute Stroke Units helps more people make a better recovery following a stroke. Every stroke patient should have access to high quality, life-saving care: centralising stroke care in hospitals throughout other large UK cities has the potential to save thousands of lives."
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