Page last updated at 01:21 GMT, Friday, 19 September 2008 02:21 UK

More GP hours 'could cut strokes'

Brain scan after a stroke
Early intervention can prevent a serious stroke in the future

Hundreds of strokes could be prevented each year if GP surgeries were open for two hours longer a day, a study says.

A study of nine practices in Oxford found people tended to turn to their GP surgery after a minor stroke, and would wait over a day if it was closed.

Rapid treatment can stop a more major attack and, in the British Medical Journal, the Oxford University team says longer opening hours could help.

The Stroke Association said people should call 999 after a minor stroke.

Even with the introduction of extended hours, there will always be times when a local GP surgery is closed
Dr Laurence Buckman, BMA GP committee chairman

Recent research found that early assessment and treatment after a TIA - (transient ischaemic attack), otherwise known as a mini-stroke - and minor stroke can significantly reduce the risk of a subsequent major stroke that causes permanent disability or death.

The National Institute of Health and Clinical Excellence (NICE) has recommended that high-risk patients must be seen within 24 hours of their symptoms appearing.

And while experts say people should go straight to hospital in order to receive the right treatment, most still contact their GP first.

Seven-day opening

The researchers looked at what had happened in the cases of patients of nine Oxford GP practices who had either a TIA or a minor stroke between 2002 and 2006.

They found that among 359 patients who had a TIA and 434 who had a minor stroke, the average time before contacting a GP after symptoms appeared was four hours during surgery opening hours (8.30am to 6.30pm) - but just under 25 hours if the surgery was closed.

Thirteen patients who presented with a stroke had had a previous TIA or minor stroke out of hours and did not seek emergency care.

The researchers assessed the impact of opening from 8am-8pm - as proposed for the 150 new GP-led health centres which the government wants to see opening across England.

The researchers said opening for those hours would have offered cover to 73 patients who waited until surgery opening hours to call their GP.

They add this would have reduced the average delay for these patients from 50 hours to four, and increased those calling within 24 hours from 34% to 68%.

Extrapolating their findings, the team said that 8am-8pm opening could prevent over 500 strokes each year in England alone.

Medical emergency

Joe Korner, of the Stroke Association, said: "Current evidence shows that people are more likely to see their GP if they have short-lived stroke symptoms.

"So longer opening hours will, as the research demonstrates, ensure that more people are referred urgently for specialist assessment."

But he added: "Calling 999 is the best course of action for all strokes and TIA.

"A TIA is a medical emergency and without treatment, about one in four people who have had a TIA will go on to have a full-blown stroke."

Dr Laurence Buckman, chairman of the British Medical Association's GP committee, said public awareness was more important that longer surgery hours.

"Even with the introduction of extended hours, there will always be times when a local GP surgery is closed.

"We need to educate patients about the warning signs of minor strokes and the importance of seeking prompt medical attention at their local accident and emergency department rather than waiting until their GP surgery is open."

Health minister Ben Bradshaw said the study "demonstrates why it is essential for patients to have access to GPs at a time convenient for them".

He added that half of GPs in England were set to offer evening or weekend appointments by the end of the year.


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