A new audit on stroke care in Ireland has highlighted persistent gaps in access to beds in dedicated stroke units and specialist multi-disciplinary staffing, which are central to best practice.
Figures from the Irish National Audit of Stroke National Report for 2024 show that while annual hospital admissions for stroke increased by 13% between 2021 and 2024, the number of stroke unit beds only increased by 2%.
The report did show continued progress in the emergency response to stroke in hospitals and in access to supported discharge.
However, the National Office of Clinical Audit (NOCA), who published the report, said the overall picture revealed "limited improvement since 2021".
The report said that access to stroke beds "remains low", despite being "the most important intervention for all patients with a stroke".
All 24 hospitals that provide acute stroke care have a designated stroke unit.
The report showed that last year, 73% of patients with a stroke were admitted to one.
This is an increase from 70% in 2021 but it is still well below the national target of 90%.
While all hospitals featured in the report reported the presence of a stroke unit, the report found that many do not fully comply with defined standards.
For example, it said that a consultant-led ward round should happen daily in a stroke unit, but this only occurs in ten out of 24 hospitals.
It also highlighted what it called "persistent staffing deficits in all disciplines" that are required to provide specialist stroke care within units.
The report concludes that the National Stroke Strategy 2022-2027 must be fully implemented to address "ongoing shortfalls" and that without targeted investment in the workforce and service capacity, progress in stroke care was "unlikely to accelerate".
'Plateau' reached around stroke treatment
The national clinical lead for the audit, Professor Joe Harbison, said that a "plateau" had been reached in some areas around stroke treatment.
"Every hospital now has a stroke unit, but too few patients are actually being treated in them," he said.
Professor Harbison said that "the implementation of the National Stroke Strategy was 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".
The report found that almost all (92%) of hospitals have a consultant physician with specialist stroke knowledge and 96% of hospitals have a 24/7 thrombolysis service.
22 out of 24 hospitals get an ambulance service pre-alert for all FAST (face, arms, speech time) calls, which the report says is an increase from 17 hospitals in 2021.
Access to early supported discharge has also improved, from 10 to 14 hospitals.
However, the report highlighted significant staffing deficits across all disciplines, including nursing, physiotherapy, occupational therapy, dietetics, psychology and medical social work.
This is the sixth national audit of stroke carried out by NOCA.
The HSE-funded body informs the general public about how specific areas of the healthcare system are performing against recognised standards of care.
