STROKE patients in Scotland are still facing a postcode lottery over their chances of making the best recovery as the latest audit shows "significant disparity" in treatment between health boards.
Almost twice as many Western Isles residents are receiving appropriate care after suffering a stroke compared to those living on Orkney, while the poorest performing of the mainland health boards - NHS Lothian - is being outstripped by neighbouring NHS Borders where an extra 15 in every hundred patients are being fully treated in time.
The variations were highlighted by the latest annual audit of stroke treatments across Scotland.
Case Study: "I thought strokes happened to old people"
Hospitals and health boards are measured on their performance in relation to four key aspects of stroke care which should be achieved within 24 hours of admission to hospital, including transfer into a specialist stroke unit, swallow screen, brain scanning, and aspirin treatment for some patients.
The percentage of patients receiving the correct bundle has risen steadily at a national level from 43 per cent in 2011 to 64 per cent in 2015, but there remains a significant variation between health boards with Scotland's second largest - NHS Lothian - only managing to treat slightly more than half (54 per cent) on time..
Case study: Ros Jack was 37 when she suffered a life-changing stroke
Other treatments, including thrombolysis - a clot-dissolving treatment for patients with acute ischaemic stroke - is increasingly being delivered within a one-hour window, with 51 per cent of patients benefitting in 2015 compared to 43 per cent in 2014.
The earlier thrombolysis is administered the better a patient's chance of recovery, but no hospital achieved the Government target to treat 80 per cent of eligible patients within the hour.
Andrea Cail, director of the Stroke Association in Scotland, said: "We are concerned at the significant disparity across Scotland in delivery of the Stroke Care Bundle – the package of care every stroke patient should get when they are in hospital.
"This has a knock on effect on supporting people to achieve the best possible recovery after stroke."
Case Study: "I thought strokes happened to old people"
Strokes remain the third biggest killer in Scotland with incident rates far higher than the average for Western Europe. They for five per cent of NHS spend in Scotland each year.
The audit finds that hospitals in NHS Lothian "continue to struggle" to admit patients to a specialist stroke unit within 24 hours of admission, while Glasgow's new flagship hospital showed the most significant year-on-year improvement with 88 per cent of patients transferred on time in 2015, up seven per cent on the previous year.
However, performance "fell significantly" at Wishaw General Hospital in Lanarkshire, from the 90 per cent national target in 2014 to 77 per cent last year, and at and Raigmore Hospital in the Highlands with a year-on-year fall from 64 per cent to 44 per cent.
Early brain scans are also required to rule out alternative causes of stroke symptoms, such as brain tumours, and to distinguish strokes caused by bleeding on the brain from those due to blocked arteries where thrombolysis is appropriate.
In 2015, the proportion of patients being scanned within four hours of admission rose from 54 per cent to 56 per cent, but varied hugely across Scotland from a peak of more than 90 per cent in the Western Isles to around 30 per cent in Ayr.
The report concludes that there "considerable variation in performance" between hospitals and "clearly scope for improving".
Public Health Minister Aileen Campbell said: “Nationally, the bundle shows year-on-year improvement in delivery and now sits at 64 per cent in 2015, which is an increase of 21 per cent over the past five years.
“However, there is still more to be done and our action plan sets out a comprehensive programme for further reducing the number of deaths from both heart disease and stroke.”
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