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Society calls for improvements in stroke care

Standards in stroke rehab units may be deteriorating, findings of a large-scale audit reveal.

More hospitals have a stroke unit than ever before, although 39 are still needed, an audit of stroke care shows. And of those hospitals that had a stroke unit at the time of the last audit in 2002, most have expanded. But the total number of stroke beds is only half that needed, according to the National Sentinal Audit of Stroke 2004. The audit of services in England, Wales and Northern Ireland, conducted by the Royal College of Physicians (RCP), notes too, with concern, that standards in rehab units may be deteriorating as more attention is paid to acute care. It says, while there has been steady progress in many elements of hospital care, there has been little matching development in community services. The audit found that only 27 per cent of hospitals in England and five per cent in Wales have specialist community stroke teams. Responding to the findings, CSP chief executive Phil Gray said people with stroke were being denied rehabilitation 'even though the evidence suggests there is still potential for improvement'.

Phil added: 'With only four per cent of stroke units having a consultant therapist on staff, there is a clear indication that more government funding is needed to increase the number of physiotherapists in both dedicated stroke units and general rehabilitation units and, indeed, ensure an equal level of care for all stroke patients in the community across the country.' Nicola Hancock, chair of the Association of Chartered Physiotherapists Interested in Neurology, said it was good news that the number of stroke units in hospitals has increased. But she said that it remains a 'very real concern' that there is still a shortfall in the number of stroke beds.

'We have further concern that the standards in rehabilitation units may fall as more attention is placed on acute care and that patients are feeling abandoned on their return to the community. 'More government investment is required to ensure equality of quality and intensity of service from the point of stroke into the patients' discharge environment and beyond.' Melody Holloway, vice chair of Agile, the clinical interest group representing physios working with older people, added: 'Given the report recognises a significant number of patients are still not cared for within specialist stroke units, it is imperative that regular nd effective training is provided for staff working outside stroke units and managing stroke patients.'

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