Welsh GPs require better stroke care

Inadequate stroke services are increasing workload and lowering morale among GPs in Wales, GP leaders say.

Results of the 2006 National Sentinel Audit for Stroke revealed that patients in Wales are more likely to die from stroke, or if they survive have higher levels of disability than in England or Northern Ireland.

Only 45 per cent of eligible hospitals in Wales were found to have a stroke unit, compared with 97 per cent of eligible hospitals in England, with only three of these hospitals able to offer acute stroke unit provision.

Poor secondary care provision is compounding the effects of high disease prevalence on workload. GPs in Wales face higher workload than the rest of the UK, because stroke prevalence is higher. Prevalence of stroke recorded in 2005/6 was 1.91 per cent, compared to 1.38 per cent in England.

Morgannwg LMC secretary Dr Ian Millington said GPs need more support to offer stroke care.

‘GPs need direct access to specialist stroke units. Once GPs diagnose a patient at risk of stroke they can admit them to hospital.

‘There is a danger that patients are not being diverted at an early enough stage,’ he said.

There has been investment in the front-end services but not in areas like radiology and imaging where there are long waiting times, said Dr Millington.

Cardiff GP Dr Gareth Hayes said that it was distressing for GPs to know that when they admit a stroke patient to hospital, they are doing so knowing the hospital will not be able to provide good stroke care.

‘It is bad for GP morale in Wales. It must be very distressing when they see the results from the National Audit for Stroke,’ he said.

Dr Tony Rudd, chair of the Intercollegiate Stroke Network, described the failure of the majority of hospitals in Wales to offer stroke unit care as scandalous.

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