Almost half of patients who need potentially life-saving stroke surgery do not get it quick enough despite guidelines being in place since 2008.
A new report from the Royal College of Surgeons and the Vascular Society of Great Britain and Ireland found 44% of people who need surgery of the neck arteries in order to prevent a stroke are not receiving it within the two week timeframe set by the National Institute for Health and Care Excellence (Nice).
While access is improving, the Nice guidelines have been in place since July 2008.
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A Government National Stroke Strategy published in 2007 set an even quicker timeframe - saying patients should only wait 48 hours from having symptoms to undergoing an operation.
People who experience symptoms of a threatened stroke or transient ischaemic attack (TIA) - often called a "mini stroke" - have a temporary disruption in blood supply to part of the brain.
They are at increased risk of a full stroke and those who have significant narrowing of the carotid artery are at high risk of having a more severe stroke, hence the need for urgent surgery.
Today's Carotid Endarterectomy Audit, commissioned by the Healthcare Quality Improvement Partnership (HQIP), found some NHS hospitals treated all patients within the Nice target of 14 days.
But others are lagging far behind and the report recommends consideration about whether their services should be moved to nearby, better-performing trusts.
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Stroke Surgery Delays: Many Patients Not Receiving Preventative Treatment