GPs must push for improvements in local stroke services

Delays in stroke surgery are declining, but GPs must continue to push local service providers to improve services, a leading stroke consultant has said.

Stroke: PET scan shows brain of a stroke patient (photo: SPL)
Stroke: PET scan shows brain of a stroke patient (photo: SPL)

Figures from the Royal College of Physicians (RCP) show a fall in the average delay from onset of stroke or TIA symptoms to initiation of carotid endarterectomy to treat narrowing of the internal carotid artery.

Professor Martin James, consultant stroke physician at the Royal Devon and Exeter Hospital said GPs needed to keep pushing local stroke services to reduce delays.

‘We’ve made progress, but there is still more that could be done,’ he said. ‘There is still a lot of variation.’

The audit found that the median delay between symptom onset and undergoing surgery was 15 days from October 2010 to September 2011. It had been 21 days from October 2009 to September 2010.

Professor James urged GPs to look at the audit's results for their local area and use the information to help drive improvements.

‘GPs need to get to know the referral method for their local TIA clinic, and push for there to be a simple telephone referral system, if there isn’t one already,’ he said. ‘That can save two to three days.’

He said GPs had already played a role in reducing delays before surgery. ‘If you look at the data, in all the pathways there are reductions in the times,’ he said.  'That’s partly because there is increased awareness of the symptoms of TIA.’

The RCP carotid endarterectomy audit has been running for six years, releasing its fourth report this week. It has collected data from 5,543 cases involving 98% of hospital trusts across the UK.

Professor James said there was a particular value in the ongoing collection and independent collection of data in this way.

‘Audit is only effective if it allows you to look at your own performance relative to others over time, and compare it to a national standard,’ he said.

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