I propose to take Questions Nos. 40, 67, 128 and 129 together.
Following the publication of Cardiovascular Health Policy Report in June 2010, the Health Service Executive (HSE) established a Stroke Programme within the Directorate of Quality and Clinical Care. The Clinical Leads for the Programme are Dr. Joe Harbison, St. James's Hospital, Dublin, and Prof. Peter Kelly, Mater Misericordiae Hospital, Dublin.
In July 2010 the HSE completed the Hospital Emergency Stroke Services (HESS) Survey for all 33 acute hospitals admitting patients with a suspected stroke. The number of Stroke Units reported was as follows:
Hospitals reporting Acute Stroke Units — 6;
Hospitals reporting a Combined (Acute and Rehabilitation) Stroke Unit — 9;
Hospitals reporting a Rehabilitation Stroke Unit — 3.
Since then, clinicians have informed the Stroke Programme that one further acute stroke unit has been opened.
Modern definitions of a stroke unit vary, however the HSE's Stroke Programme has adopted key elements common to many of these definitions, including beds in a geographically defined area of the hospital, a designated lead consultant and multidisciplinary team providing coordinated care to patients. Work is now under way to define standards for acute stroke care consistent with international definitions to support continuous improvement in acute stroke care.
In the Hospital Emergency Stroke Services (HESS) Survey hospitals reported provision of thrombolysis for acute stroke cases as follows:
24/7 service: reported by 16 hospitals;
Weekday service: reported by 6 hospitals;
Some thrombolysis carried out: reported by 3 hospitals.
The Stroke Programme is working with HSE Regional and Network management to identify the appropriate level of thrombolysis services to be provided by hospitals within acute stroke networks. Emergency care pathways will then be implemented for patients with suspected acute stroke. A training programme is under way to support clinicians to provide a safe stroke thrombolysis service for patients, with support as required from colleagues at network, regional and national levels.