At least 120 dedicated beds are needed for stroke patients in the health service over the next five years if the needs of an ageing population are to be met, according to a report drawn up by the national stroke programme.
Most stroke units are undersized and understaffed, while funding for the programme remains “a fraction” of the budget costs of other healthcare projects, the report said.
“Much has been achieved regarding improved stroke mortality with little resource in Ireland over the last five years but a big challenge lies before us with our demography and new modern treatments, with the potential to ‘cure’ many strokes,” according to the report, which was submitted as part of the estimates process.
Stroke is the second leading cause of death in the developed world and is the leading cause of acquired adult neurological disability in Ireland, as well as a major cause of dementia, depression, falls and institutionalisation in later life.
About 7,000 Irish people suffer a stroke every year, and an estimated 30,000 people are living with post-stroke disability.
In recent years, the death rate from stroke has dropped dramatically as a result of better care, and new drugs and procedures. These include thrombolysis – drugs that dissolve the clot causing the stroke – and thrombectomy, where the clot is mechanically removed.
About 300 thrombectomy procedures are done each year, at an average cost of €10,000 each. Three-quarters are performed at Beaumont Hospital in Dublin and the rest at Cork University Hospital, which moved to a 24/7 service last July. However, the report said the cost of the procedure has not been budgeted for within the two hospitals previously and forecasts that 450-500 procedures will be done in 2020.
Thrombectory has the potential to “cure” many strokes quickly, resulting in faster discharges and resumption of independent life, it pointed out. Treating just three patients will produce one more independent outcome compared to conventional treatment.
The report proposes an incremental approach to increasing staffing in stroke units, to bring them up to 50 per cent of recommended staffing in 2020, 75 per cent in 2021 and 100 per cent in 2022.
Funding is also being sought for the development of early supported discharge, and for software for the emergency stroke radiology assessment and case selection for thrombectomy.
Minister for Health Simon Harris asked Prof Ronan Collins, national stroke programme lead, to develop the first national stroke strategy in October 2017. The plan is expected to be finalised shortly.