There are “significant” staffing shortages in stroke units in hospitals, with three-quarters of recommended staff numbers vacant in some specialities, an audit has found.
On Wednesday, the National Office of Clinical Audit published a report showing continued progress in the emergency response to stroke in hospitals and in access to early supported discharge. The overall picture suggests “limited improvement” since 2021.
According to the report, there was a 13 per cent increase in hospital stroke admissions, from 6,089 in 2021 to 6,882 in 2024. During this time, the number of stroke unit beds has increased 2 per cent from 239 to 244.
All 24 hospitals that provide acute stroke care have a designated stroke unit, and in 2024, 73 per cent of patients with a stroke were admitted to one, an increase from 70 per cent in 2021. This remains below the national target of 90 per cent.
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Sixty-nine per cent of these patients’ hospital stays were spent in a stroke unit, which was below the target of 90 per cent.
Stroke units are vital for the outcome of such patients, significantly reducing mortality and disability through the use of multidisciplinary teams.
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The National Stroke Strategy 2022 to 2027 outlined a desire to ensure the stroke units “are properly staffed and not just ‘signs over doors’”.
However, the 2024 audit highlights how staffing shortages persist across all disciplines.
In nursing, there was a 31 per cent shortage, physiotherapy was 48 per cent, occupational therapy was 54 per cent, dietetics was 65 per cent, psychology was 74 per cent and medical social work was 76 per cent.
Due to these shortages, only 5 per cent of stroke patients were assessed by a psychologist last year, 24 per cent were assessed by a medical social worker, and 29 per cent were seen by a dietitian.
In the foreword, Anne Hickey, professor of psychology at the Royal College of Surgeons in Ireland, said that despite many improvements in the sector there are “concerning trends”.
“As psychological deficits (cognition, fatigue, mood) are very common after stroke, the need to increase availability of psychological services is particularly acute.”
Professor Joe Harbison, national clinical lead for the Irish National Audit of Stroke, said some areas of stroke care have reached a “plateau”.
“Every hospital now has a stroke unit, but too few patients are actually being treated in them,” he said.
“The implementation of the National Stroke Strategy is vital, not only to strengthen governance and staffing, but to ensure every person who experiences a stroke in Ireland receives the level of specialist care they need and deserve.”
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