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Stroke consultant shortage 'hurtling towards crisis' | Stroke consultant shortage 'hurtling towards crisis' |
(about 13 hours later) | |
Almost half of hospitals have a shortage of specialist stroke consultants, new figures suggest. One charity fears "thousands of lives" will be put at risk unless action is taken, with others facing the threat of a lifelong disability. | Almost half of hospitals have a shortage of specialist stroke consultants, new figures suggest. One charity fears "thousands of lives" will be put at risk unless action is taken, with others facing the threat of a lifelong disability. |
In 2016, Alison Brown had what is believed to have been at least one minor stroke. | In 2016, Alison Brown had what is believed to have been at least one minor stroke. |
But non-specialist doctors at different hospitals repeatedly told her she did not have a serious health condition. One even described it as an ear infection. | But non-specialist doctors at different hospitals repeatedly told her she did not have a serious health condition. One even described it as an ear infection. |
"I kept telling my dad, 'If I don't wake up, I love you,' because I knew there was something wrong," she tells the BBC's Victoria Derbyshire programme, having left hospital in a wheelchair. | "I kept telling my dad, 'If I don't wake up, I love you,' because I knew there was something wrong," she tells the BBC's Victoria Derbyshire programme, having left hospital in a wheelchair. |
Ten months later, aged 34, she had a bilateral artery dissection - a common cause of stroke in young people, where a tear in a blood vessel causes a clot that impedes blood supply to the brain. | Ten months later, aged 34, she had a bilateral artery dissection - a common cause of stroke in young people, where a tear in a blood vessel causes a clot that impedes blood supply to the brain. |
It had been caused by a turn of the neck while warming up for a dance class. | It had been caused by a turn of the neck while warming up for a dance class. |
She was admitted to hospital - but again struggled for a diagnosis. A junior doctor found an issue with blood flow to the brain but she says their comments were dismissed and she was told it was a migraine. | She was admitted to hospital - but again struggled for a diagnosis. A junior doctor found an issue with blood flow to the brain but she says their comments were dismissed and she was told it was a migraine. |
It was only when she collapsed again, days later, and admitted herself to a hospital with a dedicated stroke ward that a specialist team was able to give her the care she needed. | It was only when she collapsed again, days later, and admitted herself to a hospital with a dedicated stroke ward that a specialist team was able to give her the care she needed. |
Alison's case highlights the importance of being seen by stroke specialists. | Alison's case highlights the importance of being seen by stroke specialists. |
But according to new figures from King's College London's 2018-19 Ssnap (Sentinel Stroke National Audit Programme) report, 48% of hospitals in England, Wales and Northern Ireland have had at least one stroke consultant vacancy for the past 12 months or more. | |
This has risen from 40% in 2016 and 26% in 2014. | This has risen from 40% in 2016 and 26% in 2014. |
Separate research suggests there is a similar outlook in Scotland. | Separate research suggests there is a similar outlook in Scotland. |
The Stroke Association charity - which analysed the data - says the UK is "hurtling its way to a major stroke crisis" unless the issue is addressed. | The Stroke Association charity - which analysed the data - says the UK is "hurtling its way to a major stroke crisis" unless the issue is addressed. |
Its head, Juliet Bouverie, is "deeply concerned by the rate at which highly qualified stroke doctors are leaving the profession and the slow uptake of stroke medicine by new doctors". | Its head, Juliet Bouverie, is "deeply concerned by the rate at which highly qualified stroke doctors are leaving the profession and the slow uptake of stroke medicine by new doctors". |
And she has called on the government and NHS England to "act now" and make stroke medicine a more attractive proposition for junior doctors to specialise in, as well as training and developing other stroke professionals - such as specialist nurses and therapists. | And she has called on the government and NHS England to "act now" and make stroke medicine a more attractive proposition for junior doctors to specialise in, as well as training and developing other stroke professionals - such as specialist nurses and therapists. |
'Left on gurney' | 'Left on gurney' |
Carole Pyke has experienced two strokes and says she struggled for care on both occasions. | Carole Pyke has experienced two strokes and says she struggled for care on both occasions. |
In 2014, the signs of stroke were misdiagnosed as symptoms of her autoimmune condition, lupus, and she was placed on a general ward for three days before receiving an MRI scan and being admitted to a stroke unit. | In 2014, the signs of stroke were misdiagnosed as symptoms of her autoimmune condition, lupus, and she was placed on a general ward for three days before receiving an MRI scan and being admitted to a stroke unit. |
Then, last year, after going to her GP with a headache, she was told to attend hospital for a CT scan. | Then, last year, after going to her GP with a headache, she was told to attend hospital for a CT scan. |
Despite her past medical record, she was placed on a general ward for 12 hours before being sent for specialist care. | Despite her past medical record, she was placed on a general ward for 12 hours before being sent for specialist care. |
She was eventually discharged but then, two weeks later, was back in the accident and emergency department with what turned out to be a continuation of her second stroke. | She was eventually discharged but then, two weeks later, was back in the accident and emergency department with what turned out to be a continuation of her second stroke. |
She says she spent 24 hours on a trolley in a corridor before being sent to a dedicated unit. | She says she spent 24 hours on a trolley in a corridor before being sent to a dedicated unit. |
"At the time, I didn't know any better," she says. "For most of that I was there by myself, without any medical staff." | "At the time, I didn't know any better," she says. "For most of that I was there by myself, without any medical staff." |
'Game-changing procedure' | 'Game-changing procedure' |
Carole remains positive about the future. But in stroke care, a quick diagnosis is vital, as "time is brain". | Carole remains positive about the future. But in stroke care, a quick diagnosis is vital, as "time is brain". |
If patients can be seen quickly, they are also more likely to be eligible for "game-changing" thrombectomy procedures. | If patients can be seen quickly, they are also more likely to be eligible for "game-changing" thrombectomy procedures. |
By removing a clot starving blood to the brain, the treatment can help prevent lasting damage that results in paralysis and speech problems. | By removing a clot starving blood to the brain, the treatment can help prevent lasting damage that results in paralysis and speech problems. |
But there are fears such medical advances are going untapped, despite as many as one in 10 stroke patients being eligible when admitted to A&E. | But there are fears such medical advances are going untapped, despite as many as one in 10 stroke patients being eligible when admitted to A&E. |
Prof Rustam Al-Shahi Salman, president of the British Association of Stroke Physicians, says a shortage of specialists - and equipment - is preventing hospitals carrying out the treatment. | Prof Rustam Al-Shahi Salman, president of the British Association of Stroke Physicians, says a shortage of specialists - and equipment - is preventing hospitals carrying out the treatment. |
Training of ambulance staff is also important to ensure patients are always transported to hospitals with specialist stroke services. | Training of ambulance staff is also important to ensure patients are always transported to hospitals with specialist stroke services. |
An NHS official said more people were "already surviving and thriving after stroke". | An NHS official said more people were "already surviving and thriving after stroke". |
The NHS was already looking to "modernise our stroke workforce ahead of long-term funding decisions for training being made by government later in the year" and more clinicians were to be trained in delivering thrombectomy procedures. | The NHS was already looking to "modernise our stroke workforce ahead of long-term funding decisions for training being made by government later in the year" and more clinicians were to be trained in delivering thrombectomy procedures. |
The official also highlighted new ways of working in London and Manchester, where specialist care was concentrated at hyper-acute stroke units - saving "170 extra lives" a year. | The official also highlighted new ways of working in London and Manchester, where specialist care was concentrated at hyper-acute stroke units - saving "170 extra lives" a year. |
Alison says she is now managing better but will "never be the same again". | Alison says she is now managing better but will "never be the same again". |
"If there had been more experienced consultants on my visit to A&E, this could have been prevented," she says. | "If there had been more experienced consultants on my visit to A&E, this could have been prevented," she says. |
She continues to have blackouts and says when she has been taken to hospital recently, only once has there been a specialist stroke consultant on hand - and the situation is "getting worse". | She continues to have blackouts and says when she has been taken to hospital recently, only once has there been a specialist stroke consultant on hand - and the situation is "getting worse". |
"If I'd had a stroke while at those hospitals," she says, "I worry about the care I'd have received." | "If I'd had a stroke while at those hospitals," she says, "I worry about the care I'd have received." |
Follow the BBC's Victoria Derbyshire programme on Facebook and Twitter - and see more of our stories here. | Follow the BBC's Victoria Derbyshire programme on Facebook and Twitter - and see more of our stories here. |
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