Reconfiguring services - stroke
Something to consider when reconfiguring specialist services:
The Lancet Neurology reports on the experience of a pilot in Paris where a 24 hr immediate access TIA clinic cut the incidence of stroke over 1 yr post TIA.
The 90-day stroke rate was 1·24% (95% CI 0·72–2·12), whereas the rate predicted from ABCD2 scores was 5·96%.
What we do currently is organise a few basic blood tests & see them as outpatients within the fortnight. Another article shows us why that is inadequate. Other analysis here & here.
Surely it is more cost-effective in addition to clinically superior to intervene early rather than bear the costs of intensive treatment & prolonged recovery following a full stroke?
The cinderella services need greater resources. It has all been said before, to no great avail. And this is why I advocate clinically led services & commissioning, rather than the current fashion for politically prioritised fads such as extended opening hours or a poorly designed & useless IT system.
November 25th, 2007 at 1:51 pm
[...] evidence for that bleak assessment of current protocols regarding neuro-vascular injury. Manchester University researchers found that on average, patients [...]