Thousands of lives could be saved and thousands more saved from permanent disability if all patients with suspected strokes were admitted to a specialist unit and, where appropriate, treated rapidly with clot-busting drugs, an NHS watchdog said.
Stroke affects 110,000 people a year and claims 50,000 lives; it kills more women than breast cancer but has never enjoyed the high profile of other more fashionable conditions. The condition costs the NHS more than £2.8bn every year.
Strokes are caused by a loss of blood supply to a part of the brain, usually because of a clot in the blood vessel, resulting in a lack of oxygen.
But guidelines published yesterday by the National Institute for Clinical Excellence (Nice) and the Royal College of Physicians said all patients should be scanned, diagnosed and, if necessary, treated with thrombolytics (clot-busting drugs) within an hour.
Nice also said that stroke units should have immediate access to medical staff trained to deliver thrombolytics and treat strokes.
One in five patients is admitted directly to a stroke unit and just half are cared for at any time during their hospital admission on a specialist unit.
The Royal College of Physicians said that 4,500 people could be saved from disability each year. "We do not necessarily need any more resources... just better organisation of what we have already," a spokeswoman for the college said.
Those who have suffered a transient ischaemic attack (TIA) – or a "mini-stroke" – should also be diagnosed and treated within 24 hours, the guidelines say. About 20,000 people have a TIA each year – temporary loss of movement or speech – and it can signal that somebody is about to have a full stroke.
Dr Tony Rudd, the chairman of the Nice Guideline Development Group, said the Government's stroke strategy, published last year, was making headway. But he added: "Instead of waiting weeks to be assessed after a [TIA], by which time many people will already have had their stroke... patients who are at high risk should be seen and treated within 24 hours."