Dáil Éireann Debate, Tuesday - 7 November 2023
1371. Deputy Emer Higgins asked the Minister for Health the steps that are being taken to ensure continued support and services for stroke patients, given the absence of allocated funds in Budget 2024 for national stroke strategy services in 2024; and if he will make a statement on the matter. [48819/23]
View answerFollowing the announcement of the budget allocation for my Department, I will shortly be issuing a Letter of Determination to the HSE outlining my priorities and funding levels for 2024. This will be the basis on which the HSE will draw up its National Service Plan (NSP) for 2024. It is not until the conclusion of this process that a detailed breakdown of ELS/New Development expenditure will be available.
To address emerging healthcare needs of our population the HSEs National Stroke Strategy (2022-2027) underpins the work of the National Stroke Programme.
In 2020/2021, the National Stroke Strategy was developed by the multi-disciplinary Clinical Advisory Group (CAG) under the clinical governance and leadership of the National Clinical Programme for Stroke and underwent extensive consultation with internal and external stakeholders. The remit of the CAG was to produce a number of key objectives for the Stroke Strategy over the next 4 years that were; of high impact for patient care, realistic to achieve and required to ensure stroke services were adequately resourced to provide safe and effective urgent stroke care and prevention.
The HSE National Stroke Strategy was published on the HSE’s website on World Stroke Day 2022 (29th October). The strategy includes the right goals and targets and improved outcomes for patients including survival, reduced disability and the delivery of efficient and effective services that support people to live longer and in their own communities. It recommends the strategic development of the service over 5-year period 2022-2027. Four key pillars for stroke care outlined in the strategy are: 1. Stroke Prevention 2. Acute Care and Cure 3. Rehabilitation and Restoration to Life 4. Education and Research.
The recent Irish National Audit of Stroke (INAS) Report - A critical review of national stroke data for Ireland from 2013 to 2021 by the National Centre of Clinical Audit (NOCA) provides an overview of key trends in stroke care from 2013 to 2021.
The INAS is a clinically led, web-based audit that measures the care provided in hospital with a stroke against Irish and UK guidelines. The Report highlights the many positive changes in stroke care nationally. Our emergency care processes have improved considerably during the reporting period (2013 to 2021), mortality for patients with ischaemic stroke has decreased by 29%, median total hospital length of stay decreased from 11 days to 8 days and the proportion of patients seen by a medical team within 10 minutes of hospital arrival has more than doubled. Moreover, the median time to patient assessment decreased from 2.5 hours to 12 minutes so patients are being seen much faster and the thrombectomy (mechanical removal of the blood clot contributing to the stroke) rate increased from 4.8% in 2016 to 9.5% in 2021.
The report also highlights some challenges; an increase in delay from stroke onset to hospital presentation was found, therefore there is the consequent importance of highlighting public education regarding the symptoms of stroke.
INAS allows hospitals to examine their own data and promotes continuous quality improvement. Such an approach is at the heart of the delivery of safe, high-quality care. It demonstrates a commitment by hospitals to using and analysing available data, such that individual hospitals, through their clinical governance or quality and risk processes, can identify areas of concern that warrant improvement or review.
This report provides evidence of year-on-year performance improvement in our hospitals, and I look forward to this continuing into the future.
