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A report by the National Audit Office (NAO), published on 3 February 2010, concludes that the Department of Health's strategy for stroke care has increased the priority and awareness of the condition and started to improve patients' care and outcomes. However, although actions taken since 2006 have improved the value for money of stroke care, improvements have not been universal with follow-up care falling behind improvements in acute care services.
The National Stroke Strategy is a comprehensive response to the concerns raised by the NAO’s 2005 report on stroke care. The strategy has been underpinned by strong national leadership and performance indicators as well as £59 million of central funding over the first two years.
Patients treated in a specialist stroke unit are more likely to survive, have fewer complications and regain their independence. All relevant hospitals in England now have such a unit, although the services provided and time spent in units varies. Stroke patients should be immediately admitted to a specialist stroke unit but in 2008 only 17% of stroke patients reached a unit within four hours. Brain imaging is also very important but many patients are not given a scan quickly enough and access at weekends and evenings is significantly limited.
There is better awareness of the symptoms of stroke, and that it is a medical emergency, following the department's 'Stroke: Act FAST' advertising campaign, launched in February 2009.
Nonetheless, the report maintains that health and social care services are not working as well together as they could. A third of patients are not getting a follow-up appointment within six weeks and only a half of stroke survivors in the NAO’s survey said that they were given advice on further stroke prevention when leaving hospital.