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Stroke victims failed by the system

The study by the Royal College of Physicians and patient charity, the College of Health, found that stroke victims are being denied vital treatment, rehabilitation services and support for relatives.

One-to-one interviews with stroke victims and their carers revealed that many were left depressed, frustrated by the lack of services - some had even attempted suicide.

A catalogue of complaints included:

• Diagnositc mistakes;
• Delays in getting to hospital and receiving treatment;
• Criticisms of clinical care;
• Patients being treated as stupid;
• Patients not being fed, taken to the toilet or bathed.

Campaigners said the report showed "horrific failings" in the level of care provided for stroke victims.

The report was commissioned as part of the production of national clinical guidelines for stroke rehabilitation.

For the first time, patients' view were taken into account by researchers and have been incorporated into the guidelines which are set to be published later this year.

The study will make recommendations about staff training, better information about strokes for patients and carers and new patient-friendly guidelines.

Patients from across the country were interviewed about their experiences in hospital and after being discharged following a stroke.

The report found that many stroke victims were not treated in dedicated units but were left in geriatric or psychiatric wards.

Patients who were treated in specialist units praised their level of care but those in general wards were often left with poor quality treatment.

They were not given prompt or adequate access to vital services such as physiotherapy or speech therapy.

Bathed once a fortnight

One woman whose husband had a stroke while they were on holiday in Austria told of how in a foreign hospital he was bathed every night and had constant access to physiotherapy from the time he was admitted.

When he returned to an English hospital he was given a bath once a fortnight and did not see a physio for a month.

Patients who were unable to speak were not washed and went without drinks because they could not communicate, they reported.

And on being discharged, victims felt they were left to cope alone without adequate resources, knowledge or support.

Services like speech therapy and access to social workers or counsellors stopped abruptly and often elderly women were left to cope virtually alone with their severely handicapped husbands who had had a stroke.

The reports recommendations included:

• Hospital staff needed more specific training in dealing with stroke victims, including how to communicate with them and more knowledge on therapy, support and personal care;
• Patients and medical staff should together draw up an individual written programme of care as soon as possible after admission to hospital;
• There should also be a written plan of care for patients after they are discharged, with information on local services and arrangements for monitoring stroke victims after they leave hospital;
• There should be assessment of the practical and emotional needs of both stroke victims and their carers and relatives;
• The need for a more systematic nationwide approach by health authorities to ensure equality of care;
• The need for patient access to clinical guidelines so they can see exactly what treatment they are entitled to.

Chairman of the Stroke Association Professor John Marshall said: "Although we are not surprised by the results of this report we are pleased that other organisations are adding their voices to the Stroke Association's call for better services for people affected by stroke.

"An horrific failing of stroke care is revealed. The report shows that something needs to be done, and urgently."

Around 100,000 people a year fall victim to a stroke - the third biggest killer in the country and the single main cause of severe disability.

Internet Links

The Stroke Association
Royal College of Physicians
British Heart Foundation

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