An Exploration into the Service Provision and Availability of Thrombolysis Treatment for Hyper-Acute Stroke in the NHS: A Critical Review

Background Stroke is a major cause of death and adult disability in the United Kingdom. However, despite the large proportion of victims from Stroke, advances in treatment and service provision for hyper acute stroke had remained underdeveloped in comparison to other areas of the NHS. Within the last decade advances have been made in improving holistic stroke care as well as an increase in focus on the service provision for hyper acute stroke. Aim To perform a critical review of the existing literature in order to allow exploration into the area of service provision, with a particular focus on Thrombolysis delivery in relation to hyper acute stroke services. Results The results of the literature search and the application of a framework to allow the extraction of themes detailed three main themes related to hyper acute stroke service provision and thrombolysis availability. Conclusion Despite thrombolysis being proven as an effective treatment for acute ischemic stroke, some clinicians remain hesitant in delivering thrombolytic therapy to those stroke victims who meet the criteria for receiving treatment. Thrombolysis service provision is now more widespread, with improvements seen in the extension of the out-of-hours services as well as 24 hours 7 day in some centres, therefore increasing accessibility. Specialist centres which provide these services in a more effective manner are also becoming more established within the NHS. The hyper acute and holistic care received on specialist stroke units is considered by the majority of the research, to be of superior quality in comparison to a general ward. Awareness and education amongst the general public and frontline healthcare professionals is also increasing and is key to future improvements