Stroke Services

This statement is intended to demonstrate the Welsh Assembly Government’s commitment and positive action being taken on stroke services in Wales.

Although the numbers of people in Wales dying from a stroke have been falling in recent years, a total of 2,380 people died in 2005. Those people who survive a stroke are often left with varying degrees of disability and rehabilitation needs.

The 2006 Royal College of Physicians National Sentinel Audit, published earlier this year in May, states explicitly that stroke services in Wales need urgent attention. The report states that the very low rate of admissions to beds or units that are co-located and dedicated for stroke patients is unacceptable.

In response to the Audit, I immediately met the Stroke Association in June, explaining that I have made tackling stroke and improving stroke services one of my top priorities.  

Local Health Boards, which commission stroke services, have now been required to work with Social Services Departments to map current services against the stroke standards set out in the National Service Framework for Older People. The outcome of that exercise will inform the development of action plans, with clear milestones, to deliver the necessary improvements.

To oversee and co-ordinate improvements to stroke services at a national level, we have established a formal Stroke Partnership. This partnership will encourage, advise and support the NHS and Social Services in their efforts to provide the quality of care that stroke patients need.

The Stroke Partnership is made up of three key national organisations, namely the National Public Health Service, the Wales Centre for Health and the National Leadership and Innovations Agency for Healthcare.  The Partnership is working closely with the Stroke Association.

We need our doctors, nurses and other health professionals to champion and lead the change programme. I am, therefore, pleased to report the recent establishment of the Wales Stroke Alliance. This is a multi-disciplinary clinical collaborative, led by Dr Anne Freeman, a physician at the Royal Gwent and a Trustee of the Stroke Association, whom I also met in June. The Alliance will directly underpin the Stroke Partnership and input in to and support its work. I believe this is a very exciting and innovative model for tackling the improvements we must deliver.

The Welsh Assembly Government, working with the Stroke Partnership, the Wales Stroke Alliance and the Stroke Association have developed a formal programme of work for stroke services for the next few years. Much of the early requirements of this programme focuses on the work of the Stroke Partnership, which will develop an agreed care pathway and national protocols to inform local decisions on commissioning and delivery of services.  

An early priority in terms of service improvement is the requirement that, by March 2009, all stroke patients must be admitted to dedicated and co-located beds staffed by a multi-disciplinary medical and acute rehabilitation team.

I intend this programme of work to act as a firm and positive driver and a focus for the improvements we need to achieve.  The programme is being issued to the NHS and Social Services via a Welsh Health Circular and I expect my Regional Offices to monitor progress with it carefully. The programme will be reviewed periodically in the light of progress.

To ensure that these improvements are implemented promptly, and as part of the One Wales commitment to improve services for long-term conditions such as stroke, I am proposing to make £2.5 million available from 2008-09. Decisions on the use of this funding will be made in the light of the work LHBs are doing to map current services against standards.