Tories plan a bonfire of the NHS targets in bid to save 100,000 lives

David Cameron has set out his vision for the health service, with a promise to save 100,000 lives a year by giving patients more information and more power over their own care.

Labour’s internal NHS targets will be ditched and patients simply told which hospitals get the best results, under the radical Tory plans.

“How long will my dad survive if he gets cancer? What are my chances of a good life if I have a stroke? What are my chances of surviving from heart disease? This is the kind of information people want and need,” Mr Cameron planned to say.

He was also listing a series of goals - reminiscent of New Labour's 1997 pledge cards - so that voters could hold a Conservative Government to account over its handling of the health service.

These include:

* raising cancer five year survival rates to above the EU average by 2015

* cutting early deaths from stroke and heart disease to below EU averages by 2015

* cutting early deaths from lung disease to below EU averages by 2020

* annual improvements in survival rates and quality of life for patients living with long-term conditions.

The Tories chose the 60th anniversary of the creation of the NHS to unveil their “Green Paper” on health policy, ‘Delivering some of the best health in Europe’, before an audience at the Royal College of Surgeons in London.

Mr Cameron has been eager to stress his commitment to the service, and neutralise Labour claims that a Tory Government would downgrade it.

He argued that Labour has strangled the NHS in red tape, “testing to destruction the idea that the NHS can be improved by more bureaucracy, more central control and more initiatives from the Department of Health”.

According to the Tories, raising NHS standards to the European average would save around 38,000 lives every year, but their “ambition” is to lift performance to match the best systems in the world, which would save at least 100,000.

Mr Cameron insisted that outcomes are the only thing that matters for patients: “What matters is the result itself, not how it is achieved.”

Niall Dickson, chief executive of the King’s Fund, welcomed the plans.

“(The Conservatives) are right that what matters to patients is whether their quality of life has improved following surgery or any other procedure rather than whether top-down targets have been met," he said.

’But the Conservatives’ plan to abolish central targets needs to be considered carefully. Before we drop central targets altogether, we must be sure that there are appropriate safeguards to ensure standards and aspirations are in place.”

From:
http://www.timesonline.co.uk/tol/news/uk/health/article4204107.ece

£77m to improve stroke services as UK 'lags behind major Western nations'

The UK lags behind other developed nations in caring for thousands of patients who have suffered a stroke, and the labour Government is far from meeting its own targets in England, a new critical report says.

It comes as the Government announced that £77 million will be spent over the next three years as part of a national stroke strategy, unveiled last year.

Ministers said that every local health authority in England should appoint a dedicated stroke care coordinator to support stroke survivors and their carers.

But a report by The Health Foundation, an independent charity which seeks to promote good practice within the NHS, and seen by The Times, concludes that “stroke services are still not good enough”.

It shows that less than half of patients in England (43 per cent) receive a brain imaging CT scan within 24 hours of suffering a stroke. This is despite national guidelines which state this is required for all patients who have suffered a major blood clot or bleeding in the brain, to be given a brain scan within three hours, or one hour after arriving at hospital.

There are nearly 900,000 people in England living with the consequences of a stroke, and it is the third biggest cause of death in the UK. In England alone there are more than 110,000 strokes each year, and it is the leading cause of long-term severe disability in adults.

The report adds that Britain lags behind other major Western countries in deaths due to cerebrovascular disease — a disease of the blood vessels supplying the brain, which often leads to a stroke.

The UK achieved a 16 per cent fall in mortality between 1997-2004, whereas Germany saw more than double (33 per cent) this reduction during the same period.

The charity is funding a NHS programme in the North West of England, which aims to boost the number of people who could survive a stroke by 30 per cent by 2010, and increase the number of stroke survivors walking out of hospital without a long-term disability. The programme is being run in partnership with the Stroke Association and the Royal College of Physicians.

But the foundation’s report also stressed the importance of preventative checks and treatments, suggesting that as many as 69 per cent of strokes in inner London could be prevented by prior screening and reductions in blood pressure, treating abnormal heart rhythms, stopping smoking and prescribing statins to at risk patients.

Bread and cereal manufacturers could also prevent 8,000 strokes a year in England by reducing their salt content, it suggests.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article3889634.ece

Strokes- postcode lottery for stroke scans costs lives

Thousands of stroke victims die unnecessarily every year because access to the best care is subject to a "postcode lottery", campaigners have said.

Figures highlighted by the Stroke Association yesterday showed that patients in some parts of England were almost 60 per cent more likely to get a potentially life-saving brain scan diagnosis within 24 hours than those in other regions.

They also revealed that people suffering a stroke in the East Midlands were almost 30 per cent less likely than those in the North East to be treated in a hospital stroke unit with specialist equipment and staff.
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Alan Johnson, the Health Secretary, today set out the Government's new 10-year strategy to accelerate the emergency response to strokes and improve prevention and access to the most effective treatment.

Mr Johnson said that patients suffering a full stroke should have a brain scan in the next available scanning slot during normal working hours, while outside these hours they will receive a scan within 60 minutes before being moved to a stroke unit.

Higher-risk people suffering a minor stroke should have an MRI (magnetic resonance imaging) scan within 24 hours, while patients considered "low-risk" will
have access to a scan within seven days.

Joe Korner, of the Stroke Association, said: "Stroke is the UK's third biggest killer. Despite clear clinical evidence that access to immediate brain scanning and admission directly to a stroke unit saves lives and reduces disability, current access to these life saving facilities is down to luck and postcode."

Strokes are either blood clots or bleeds in the brain, which can leave lasting damage including speech, mobility and sight problems. Approximately a third of the 150,000 people who have a stroke in the UK each year die of it.

A scan is the only way to determine what type of stroke the patient is having and the best way to decide on the most effective form of treatment.

Data collected by the Royal College of Physicians found only 42 per cent of patients in England receive a brain scan to confirm their diagnosis within 24 hours.

New treatments with clot-busting drugs - called thrombolysis - can result in a much better and quicker recovery.

However the drugs must be given shortly after the onset of symptoms to be effective, and can only be used after a brain scan.

An estimated one in 10 stroke patients would benefit from thrombolysis, yet just one in 10,000 receive it.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/12/05/nhs305.xml

On 27 Aug 07 Health Direct posted UK stroke treatment is worst in Europe with hundreds needlessly dying every year- The UK has the worst outcome for strokes in western Europe despite spending the same amount or more on care as other countries, a leading article in the British Medical Journal warned.

And it is nearly two years since MPs in the National Audit Office pointed out that hundreds of UK citizens are dying needlessly and over a year since Health Direct posted on July 12, 2006- Stroke patients dying needlessly from Labour's health failures

Since then new Prime minster- same lack of compassion and urgency.

Stroke patients are needlessly dying or suffering more serious disablement because not enough priority is given to stroke services, according to a report by the Commons Public Accounts committee.

The report found that stroke is not treated as a medical emergency, brain scans for patients are often delayed and a significant proportion of stroke patients are not treated on specialist units.

UK stroke treatment is worst in Europe

The UK has the worst outcome for strokes in western Europe despite spending the same amount or more on care as other countries, a leading article in the British Medical Journal warned.

Hugh Markus, professor of neurology at St George’s university and medical school, said three different studies had put the UK at the bottom among several other western European countries.

The problem appears to lie in the way services are organised, with strokes seen as a “Cinderella” subject that falls between neurology and geriatric medicine, Prof Markus said.

Instead it needs to be treated as “a condition that requires emergency action”.

Clot-busting drugs can now be given to patients whose stroke is due to a blocked blood vessel rather than a broken one.

To do that, however, rapid 24-hour access to specialised expertise and imaging equipment is needed to determine the type of stroke. The drugs have to be given within three hours to have most effect and can harm a patient whose stroke is due to bleeding.

“It is unlikely that every acute hospital will be able to provide such a service,” Prof Markus said, and alternative strategies that include regional centres and the use of telemedicine are needed, as in Germany and America.

“In many European countries,” Prof Markus added, brain imaging “is performed on admission to the accident and emergency department, while in the UK many units struggle to provide it within 24 hours.”

A National Audit Office report in 2005 calculated that 550 deaths could be avoided a year, and 1,700 patients would recover fully rather than being disabled, if ­services were better organised.

A stroke strategy is apparently due to be published by the health department in the next few months.

The limited data available, Prof Markus said, “show that European countries with better outcomes focus resources more heavily on the acute aspects of care”.

“The vast majority of the cost of in-hospital stroke care in the UK is for nursing and hospital overheads, with the cost of investigations and medical care being very low.”

At present less than 1 per cent of patients eligible for clot-busting drugs get them in the UK, against 20 to 30 per cent in many European countries and North ­America and Australia.

From:
http://www.ft.com/cms/s/0/d7bdb1d6-518f-11dc-8779-0000779fd2ac.html

It is nearly two years since MPs in the National Audit Office pointed out that hundreds of UK citizens are dying needlessly and over a year since Health Direct posted on July 12, 2006- Stroke patients dying needlessly from Labour's health failures

Since then new Prime minster- same lack of compassion and urgency.

Stroke patients are needlessly dying or suffering more serious disablement because not enough priority is given to stroke services, according to a report by the Commons Public Accounts committee.

The report found that stroke is not treated as a medical emergency, brain scans for patients are often delayed and a significant proportion of stroke patients are not treated on specialist units.

The MPs found:
* Stroke is not treated as a medical emergency in the same way as a suspected heart attack, though the shorter the time between the stroke and the treatment, the greater the chance of reducing damage to brain tissue.
* Brain scans for many stroke patients are being delayed, though a scan is vital for determining appropriate treatment.
* A significant proportion of stroke patients are not being treated on a specialist stroke unit, despite evidence that this is the most clinically effective model for acute care.
* There is considerable variation between hospitals as to what a specialised stroke service entails.
* Public awareness of the symptoms and impact of stroke, and how strokes can be prevented, is very low.
* There are insufficient nursing, therapist and other specialist staff with expertise in stroke care across the primary and secondary healthcare sectors, and there is scope to improve training for the existing stroke workforce in the National Health Service (for example, by training stroke consultants to interpret brain scan results).
* The carers of stroke survivors, and stroke survivors living on their own, are often not accessing the social and care services they need.
* There is low awareness on the part of members of the public and general practitioners about the fact that a transient ischaemic attack ('mini stroke') is a strong indication of increased risk of major stroke, and requires immediate investigation and treatment.