Since the establishment of the HSE National Clinical Programme for Stroke in 2010, there have been significant improvements in stroke care. Overall mortality from stroke has reduced significantly. Just over a decade ago, two in every ten people died after they had a stroke in 2010. Today, that has dropped to 1 in every ten. The number of acute stroke units has climbed from 1 to 22 units, and the use of a clot dissolving therapy (called thrombolysis) as well as clot removing procedures have increased. The number of people having strokes each year has fallen by about 25% from 10,000 to 7500. It’s evident that significant progress has been made and this government is fully committed to supporting further improvements and advances in stroke services.
The HSE National Stroke Strategy 2022-2027 provides a blueprint for required investment in stroke services over the five-year period from 2022-2027. The stroke strategy focusses on the entire pathway of patient care under four key pillars; stroke prevention; acute care and cure; rehabilitation and restoration to living; and education and research.
Progress is being made with this Government allocating over €7 million in additional funding to the HSE National Stroke Strategy over the last two Budgets, delivering on our Programme for Government commitments. Under the prevention pillar, instances of stroke will be prevented through the expansion of the GP Contract to include opportunistic case finding of High Blood Pressure, (a principal risk factor in stroke) in over 45-year-olds with a GMS/GP visit card. The HSE advise that this contract is now in place and the service commenced in Q1 this year. Another key risk factor for stroke, atrial fibrillation, has been screened for through this programme since 2017. A media campaign was carried out in 2023 to highlight the warning signs of stroke and a further campaign is planned for Q4 2024 which will help people get to hospital earlier and save lives.
In terms of recruitment, funding for 25 staff was made available in Budget 2023 for the recruitment of a range of posts including consultants, nurses and health and social care professionals to support the development of the strategy. Prior to the introduction of the HSE Recruitment moratorium, 12 staff were recruited including 3 consultants to support our Specialist Acute Stroke units and our endovascular thrombectomy services. A speech and Language Therapist has also been recruited to support our acute stroke units. The stroke strategy details the health and social care professional staffing gaps in our acute stroke units that are to be filled over the lifetime of the strategy.
A total of 8 staff across a range of health and social care professions have been recruited to expand our Early Supported Discharge Team network, an evidence-based model of care to intervene early following a person’s stroke, and which is proven to reduce hospital length of stay, and may return up to 5500 bed days to the hospital system. There are now 11 out of the 21 teams operational nationally as envisioned under the strategy compared to 6 teams prior to implementation.
In addition, further progress is being made in community services available to survivors of stroke. The roll out of community neurorehabilitation teams in the community will support stroke survivors with recruitment of teams being progressed at demonstration sites in four CHO areas. In primary care, the roll out of the Enhanced Community Care Programme will also support stroke survivors including 27 of the planned 30 Community Specialist Teams for Older People, and 26 of the planned 30 Community Specialist Teams for Chronic Disease now being fully operational.
In summary, while we have made some progress on implementing the stroke strategy, more needs to be done and this government and I as Minister for Health are absolutely committed to working with the HSE to ensure its successful implementation to further reduce mortality from stroke, as well as supporting survivors of stroke to live as independently as possible in their communities.
