Stroke Services

Part of the debate – in the House of Commons at 7:05 pm on 5th December 2017.

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Photo of David Amess David Amess Conservative, Southend West 7:05 pm, 5th December 2017

Even though money is tight, I absolutely agree with my hon. Friend. I have seen a video of the operation, and it is just extraordinary that a catheter can be inserted into a patient’s artery to access the clot, which is then mechanically removed. The technology is extraordinary.

Mechanical thrombectomy significantly reduces disability rates after strokes. It removes clots that are too big to be broken down by drugs alone. For each six-minute delay in the delivery of mechanical thrombectomy, there is a 1% increase in the proportion of people who become disabled. Royal College of Physicians guidelines for stroke care label it as the best recommended practice. It is an effective procedure with very low complication rates. It is highly cost-effective, too. The Stroke Association has calculated that over a 10-year period, the net monetary benefit of 9,000 eligible patients receiving the treatment would be between £530 million and £975 million.

Mechanical thrombectomy enables more stroke survivors to live independently in their own homes, which is crucial, and then to return to work and take control of their lives again, thereby saving the NHS money. It really is a game-changing treatment that could revolutionise stroke victims’ experiences, yet despite NHS England’s agreeing to fund it, it is delivered for only 0.008% of the 85,122 acute stroke admissions, versus the EU benchmark of 3%, so we are really some way behind.

Let me blow the trumpet for Southend, following on from what my hon. Friend James Duddridge said earlier. Southend has been developing an interventional neuroradiology service alongside a hyper-acute stroke service providing thrombectomy. Our service is led and delivered by an interventional neuroradiologist. It has been developed with the local trust board since 2013, but due to a current recommendation that only interventional neuroradiologists can perform the procedure, she is the only person who can perform thrombectomy at the moment, so the service is provided on a “best endeavours” basis and is not, unfortunately, a regular service. The service is currently available only at Southend and nowhere else in Essex. We need to expand it to provide a 24-hour service. The only other place where it is provided is at St George’s Hospital in London.

Mr Paul Guyler, who is a lead consultant in stroke medicine at Southend University Hospital, tells me that less than 1% of ischaemic stroke patients receive endovascular treatment and that, despite around 9,000 patients being eligible for mechanical thrombectomy, only 400 patients received the treatment last year. He has argued that the barriers to this treatment revolve around skills and education, resources and attitudes.

This is not a criticism of my hon. Friend the Minister, because he cannot wave a magic wand and solve all these problems, but Mr Guyler has advised me that there are not enough trained specialists to be able to provide a 24/7 service in all areas. Unfortunately, we also have a postcode lottery, with not enough neuro- radiologists and only 80 interventional neuroradiology operators in the United Kingdom.