Question reference: S6W-02307
- Asked by: Alexander Stewart, MSP for Mid Scotland and Fife, Scottish Conservative and Unionist Party
- Date lodged: 17 August 2021
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Current status: Answered by Humza Yousaf on 4 October 2021
Question
To ask the Scottish Government what criteria need to be met in order for an area of a hospital to be designated a stroke unit; how the capabilities of stroke units have been maintained during the COVID-19 pandemic to ensure that people who survive a stroke receive full stroke unit care; which NHS boards have had their stroke units downgraded during the COVID-19 pandemic, and how many stroke patients have had their recovery impacted as a result.
Answer
The core criteria for defining a stroke unit are well described in the academic literature, including in Langhorne et al (2002). Though the size and configuration of stroke units across Scotland may vary depending on local factors, most will be in a defined ward setting and have a specialist stroke multidisciplinary team.
Covid-19 has had an unprecedented impact on the world, NHS Scotland and stroke services. Each service will have responded in the best way that it could, depending on the specific issues affecting them.
The 2021 Scottish Stroke Improvement Programme Report (which includes 9 months of the pandemic) shows slight deterioration in performance against the stroke standards for stroke unit access (77% in 2020 compared to 82% in 2019).
While stroke unit access declined, achievement of standards in other areas, including brain imaging within 12 hours of arrival (86% in 2020 compared 84% in 2019), time to carotid intervention (61%; 59%) and mean thrombolysis door-to-needle (DTN) time (51 minutes in 2020 compared to 53 minutes in 2019), improved.
All of these aspects also have an important impact on recovery from stroke, and therefore it is not possible to isolate the recovery impact based on one standard (such as stroke unit access).