NEWS
Thrombolysis considered for more stroke patients
The latest national clinical guideline for stroke recommends that all patients, regardless of age or how severe their stroke is, should be considered for thrombolysis. ew research has shown that these categories of patient, formerly not thought to benefit from thrombolysis, should now be offered it with other patients within three hours of the appearance of stroke symptoms. The recommendation is one of several
updates to the guideline, which aims to improve the quality of care for stroke patients. It includes over sources of evidence of major developments in stroke research during the past four years, and continues to include the IC quality standards and guidelines for stroke care. ajor recommendations, and changes to the previous guideline include:
∑
Commissioning stroke services across the whole stroke pathway, from acute to long- term care. ehabilitation therapies should be
Funding for advanced cancer treatment
∑
Almost 8, more cancer patients a year could benefit from the rollout of an advanced radiotherapy technique with fewer side effects, following the announcement of a £ 5 million investment by the Government. The Cancer adiotherapy Innovation
Fund will expand the HS' capacity to deliver advanced radiotherapy techniques by April 3. The money will be used to speed up the use of Intensity odulated
adiotherapy (I T) across the HS. The technique targets more precise doses
of radiation at a tumour, while minimising the impact on surrounding healthy tissue. It is particularly beneficial for patients with head and neck cancers, reducing the likelihood of side effects like damage to salivary glands, which make it difficult to enjoy and digest food.
commissioned alongside these services and available for the whole pathway. All acute patients should be considered for thrombolysis regardless of age or stroke severity.
∑ Patients with stroke should be offered 45 minutes of appropriate therapies for a minimum of five days a week in the early stages after stroke. This is to enable the patient to meet their rehabilitation goals and should continue for as long as the therapy is of benefit and the patient can tolerate it.
∑ Prescribing the anti-platelet drug clopidogrel as the first-line treatment after both stroke and transient ischaemic attack (TIA) because it is better tolerated and more cost- effective, and to ensure a unified approach to managing both conditions. This contradicts the most recent IC guidance, which recommends aspirin for TIA because clopidogrel is currently licensed only for the treatment of stroke and not TIA.
All patients should have a brain scan within a maximum of hours. This is a reduction from the previous 4 hours to ensure all patients admitted out of hours are scanned the following day.
∑ Carotid endarterectomy for asymptomatic carotid stenosis should not be routinely undertaken, other than in exceptional circumstances or as part of a randomised controlled trial.
Professor Tony udd, chair of the Intercollegiate StrokeWorking Party, said:
™ This stroke guideline is the most comprehensive ever produced and acts as a template for the commissioning, organisation and delivery of stroke care at a time of major upheaval in the health service. It reinforces the message that care needs to be integrated all across the stroke care pathway, no matter who is providing the care.∫ For more information visit:
www.rcplondon.ac.uk/stroke
Government offers £20 m to NMC
Health inister Dr Dan Poulter has announced that the Government has offered the ursing and idwifery Council ( C) a one off grant of £ million to improve the C' s performance. The Government said it expected the grant would protect nurses and midwives from the full impact the original proposed registration fee rise of almost 6 %. Annual registration has historically cost every nurse and midwife £76 per year, but the
C recently consulted on increasing its annual fee to £ . This would have meant that nurses and midwives would pay an extra £44 every year. The Government wanted the grant
to help the C to properly tackle a backlog of fitness to practice cases, as well as to allow it to reduce the effect of a fee rise for nurses and midwives. Health inister Dr Dan Poulter said:
™ Following a period when we have heard of so many terrible abuses in the care of older people and vulnerable patients, it is important that organisations like the C are in the right shape to properly perform their job of protecting patients.∫ The C later accepted the government' s
offer to support the costs of regulation and decided to raise registration fees to £ a year.
13
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