Call for 24-hour GP referral for TIAs

GPs should be able to refer patients who have had a minor stroke to a specialist clinic within 24 hours, according to a report into the performance of rapid-access stroke clinics.

The report by the University of Manchester's clinical neurosciences group looked at the performance of minor stroke and TIA clinics at five hospitals in the North West of England.

It found patients were waiting an average of 15 days to be seen, more than twice as long as the recommended guideline of a week.

The report recommends an overhaul of the clinics structure to ensure TIA and minor strokes are given, 'priority status and treated as an emergency', according to Dr Craig Smith a member of the clinical neurosciences group.

'At the moment GPs are referring patients to these clinics but often they are held just once a week. I would like to see an overhaul of the service to ensure GPs can refer a patient to the clinic within 24 hours,' he said.

'Another option is to use A&E more. I believe that TIA is an emergency situation and it does not get that recognition across the health service. I'm not saying that every case should be referred to A&E but with appropriate resources, they may have a role to play here.'

The report, called 'Prognosis in patients with TIA and minor stroke attending TIA services in the North West of England', says an overhaul of the way minor strokes are dealt with is vital because of the high risk of a subsequent major stroke.

Previous studies have put the risk as high as one in four cases. This puts an increasing strain on workload in primary care, showing the economic argument for identifying and treating minor strokes at an early stage, according to Dr Smith.

The 711 patients in the study were monitored for three months after visiting the clinic. It was found that one in five had a major stroke or another TIA during that period. The report says the survey's findings are representative of the UK as a whole and estimates that only around a third of UK minor stroke clinics are hitting the seven-day standard.

Dr Smith said that practices could also do more in terms of prevention, by ensuring they are informing middle-aged men who smoke of the risks of TIA.

'Practices have a role to play in health promotion, ensuring that high-risk patients are aware of the symptoms and ways to limit the risk,' he added.

GPletters@haymarket.com

University of Manchester report

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