Stroke patients abandoned after hospital treatment, Oireachtas hears

The Irish Heart Foundation (IHF) and Croi, the West of Ireland Cardiac & Stroke Foundation, have highlighted 'huge gaps' in aftercare and shortfalls in some treatments.

Patients successfully treated for stroke or heart attacks are then abandoned due to the lack of after-care support, the Oireachtas Health Committee has been told.  

The Irish Heart Foundation (IHF) and Croi, the West of Ireland Cardiac & Stroke Foundation, have highlighted “huge gaps” in aftercare and shortfalls in some treatments.

The charities were particularly critical of the lack of a coherent implementation strategy from the Department of Health on existing policies.

They said this is extremely frustrating as Ireland has seen “a huge reduction”, of around 25%, in deaths from stroke over the last decade due to medical interventions.

Esther O’Shea, an IHF patient advocate living in rural Cork, said patients like her are successfully discharged from hospitals daily.

“Patients have nowhere to go, they have no pathway and no care plan when they come out of hospital,” she said.

“We are forgotten about after discharge”.

“People at night, who are newly diagnosed, who are living with a chronic illness, are afraid to go to sleep because they are afraid they will not wake up in the morning.” 

Cardiac Services Review

Ms O’ Shea attended a public consultation six years ago on the National Cardiac Services Review but this strategy has not yet been published.

Mark O’Donnell, Croi chief operations officer, and in-coming chief executive, supported her call to publish this.

Key recommendations in this have not been signed off on, and he said: “We understand it is currently with the Minister and would urge that it is progressed without further delay.” 

Chris Macey, IHF Director of Advocacy and Patient Support, said another policy, the National Stroke Strategy 2022-27, has been published but “is not being coherently implemented”.

There is now “growing concern” that an additional 70 to 75 posts required for that will not be filled, he said.

Budget shortages also affect treatment, he told Sinn Féin health spokesman David Cullinane.

“The national target for getting people into stroke units is 90%,” he said.

“What we’ve got to is 70%, and getting into a stoke unit is the difference between leaving under your own steam in a relatively good condition or death or permanent, severe disability in 20% of cases.” 

“There are 6,000 stroke patients going into hospitals every year, so 1,800 are not getting into a stroke unit.” 

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Social Democrats health spokeswoman Roisin Shortall asked if there is “a blind spot” in the Department around heart health.

IHF policy manager Kathryn Reilly said “a real impediment” is the lack of a national policy for all these areas and “the lack of any designated officials within the Department of Health to drive it".

Levels of stroke and heart disease are expected to rise, the charities warned. They linked this to an ageing population, a less healthy diet across all ages, rising rates of obesity, and smoking.

Over half a million people are living with a cardiovascular condition, with 80,000 discharged from hospital annually. 

A Department of Health spokeswoman said the National Cardiac Services Review will be published after it has been discussed by Government, adding this is “expected shortly”.

She said the review was delayed due to the pandemic and only completed in 2022, with a report submitted to the Department in September of this year.