Donegal stroke patients have less chance of survival

By June Shannon Stroke News   |   28th Jan 2020

The Irish Heart Foundation seeks pledge from election candidates to open stroke unit in Letterkenny

Letterkenny University Hospital in Donegal is the only acute hospital in the country treating stroke patients that does not have a stroke unit, meaning patients in this area have considerably less chances of surviving or recovering from their stroke than patients in the rest of the country, the Irish Heart Foundation has said.

Calling on election candidates to guarantee to open a stroke unit in Letterkenny Hospital this year if in Government after the general election, the national heart and stroke charity described the failure to open a stroke unit in the Donegal hospital as “disgraceful.”

In a letter sent to candidates yesterday (Monday 27th January), Mr Chris Macey, Head of Advocacy at the Irish Heart Foundation, said that stroke unit care was recognised in published guidelines in every country where they exist as the most fundamental element of stroke care.

“This is not care that is impossible to deliver on a large scale because of its cost, or complexity,” he said.

“Stroke units represent a basic standard of care internationally and the HSE’s own Stroke Programme has concluded that they more than pay for themselves by reducing requirement for expensive nursing home care and reducing length of stay in hospital.

“It is disgraceful that Letterkenny University Hospital is now the only acute hospital treating stroke in the country that doesn’t have a stroke unit. In other words, patients in Donegal are the only ones nationally not to feel the impact of dramatic improvements in acute stroke care and have considerably less chance of surviving or recovering from a stroke than patients in the rest of the country,” Mr Macey added.

" Patients in Donegal are the only ones nationally not to feel the impact of dramatic improvements in acute stroke care ,"

Mr Chris Macey, Head of Advocacy , Irish Heart Foundation

In the ten years to 2018 the number of acute stroke units in Ireland increased from one to 23. At the same time stroke and stroke related deaths fell from 2,114 to 1,680 nationally – a reduction of more than 20 per cent.

The Irish Heart Foundation, which runs a weekly stroke support group in Letterkenny said it was “unjustifiable” that patients were still not benefiting from stroke service improvements that have cut deaths from the disease in the rest of the country by more than 20 per cent in the last 10 years.

Consultant Geriatrician at Letterkenny University Hospital Dr Ken Mulpeter has estimated that the absence of a stroke unit is costing the lives of as many as 12 patients a year who are admitted to Letterkenny University Hospital.

“ The absence of stroke unit care for patients in Donegal years after it became available in much of the rest of the country is inexcusable and must be urgently addressed."

Mr Chris Macey, Head of Advocacy , The Irish Heart Foundation

Mr Macey said there was no doubt that many more stroke patients were being forced to endure disabilities of greater duration and severity than would be the case with access to a functioning stroke unit.

He added that in terms of cost, the HSE’s own National Stroke Programme estimated that from 2010 to 2014 alone, direct discharge to nursing homes fell from 17.7 per cent of patients to 13.8 per cent. This cut the cost of long-term care by an estimated €160 million, at a nominal cost of €4.2 million, which was the investment provided to develop the stroke unit network. Average length of hospital stay also fell from 21 days to 17 days, reducing in-hospital costs and freeing up beds for other patients.

“The absence of stroke unit care for patients in Donegal years after it became available in much of the rest of the country is inexcusable and must be urgently addressed. Within the CHO1 region the HSE has been extremely supportive of services for stroke survivors and provides vital assistance that enables the Irish Heart Foundation to meet their support needs. But at a national level stroke services have been starved of investment and the failure to provide a stroke unit for patients in Donegal is a product of that neglect.

“We are asking each candidate to give a guarantee that if they or their party are in Government after the general election, a properly configured stroke unit will be operational in Letterkenny before the end of 2020 at the latest.”

For information on the Irish Heart Foundation’s stroke support groups please see here

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