The Bolton-born professor who transformed the way strokes are treated
MOST of us probably have a relative or friend who has suffered a stroke and are all too aware of how common this can be.
Yet the way stroke patients are treated has been transformed over the past 30 years — a transformation largely thanks to Bolton-born stroke expert Professor Tony Rudd.
Prof Rudd moved to London with his family at the age of four.
He jokes: “As soon as my parents detected my slight Lancashire accent, we moved away. My father was a factory inspector and I remember being shown around Bolton School when I was four.”
The father-of-four went on to study medicine at Cambridge and later to King’s College in London.
But it was when he started working as a geriatric physician at St Thomas' Hospital in London 26 years ago that he began to make waves in stroke care.
His subsequent transformation of stroke services at St Thomas’ and later across London have led to his reputation as a pioneer for the treatment of the disease.
He explained: “At the time, stroke services in London were chaotic and unco-ordinated and it needed sorting out.
“The problem was that stroke was not seen as a specialist area of medicine and was treated by general physicians. People thought it was a disease you could not treat. It was seen as something that happened to older people and there was little else that could be done to help them.
“But over the past 25 years things have changed. We now know it is a treatable and preventable condition and that having the right treatment can have a dramatic effect on the patient.
“Now, across London and to some extent nationally, we have co-ordinated care in stroke with specialist doctors, nurses, physiotherapists and occupational therapists.
“It is about producing a system where people can be assured they will get high quality care.
“We’re not there yet across the rest of the country but it is certainly better than it was.”
Prod Rudd’s career as stroke expert has gone from strength to strength during his time at St Thomas’ and last April he was made NHS England’s National Clinical Director of Stroke.
Thanks to 59-year-old’s leadership as stroke director for London, 95 per cent of stroke patients in the capital are seen in one of eight hyper-acute stroke units (HASUs) rather than across all of the city’s 32 hospitals.
These eight specialist stroke units could be seen as an example of how other specialist services will be organised across Bolton and Greater Manchester in the future.
The idea is that patients receive the most appropriate treatment for their condition, at the right time to the highest standard of care. “At our eight stroke units we have specialist staff on duty 24 hours a day, seven days a week. This would just not be possible across all 32 hospitals,” said Prof Rudd.
“Once stroke patients have been in these units for three days and have improved, they are then sent back to their local hospital.”
‘Clock-busting’ treatment is essential for a patient who has just suffered a stroke.
“The first three hours after a stroke are critical in terms of the damage it can do to the brain and the body, such as paralysis or speech impairment.
But the right care and rehabilitation can have a dramatic effect, according to Prof Rudd.
He said: “It is vital stroke patients receive the right rehabilitative care once they have been discharged from hospital. Otherwise, once they are sent home, all of the work with the specialist teams will be undone, and more people end up in nursing homes or can’t go back to work.
“Obviously, that costs the NHS more money in the long run. What we now know is that if you invest money in the care at the beginning of stroke treatment, you can save money further down the line.”
Stroke is the third most common cause of death after heart disease and cancer and the most common cause of adult disability.
But like heart disease, people can make their own preventative steps by watching their diet, alcohol intake and not smoking to help lower their blood pressure.
Vigorous exercise and the increased popularity of recreational drugs also increases the risk of stroke.
He added: “Seventy per cent of all strokes could be prevented if we all behaved ourselves, but of course we don’t.
“But it’s not just young people that indulge, it is older people too. But the risk of a stroke should be enough not to.
“The Government has a part to play too and I welcome their decision to review plain cigarette packaging.”
One thing Prof Rudd is reluctant to talk about is his CBE, which he modestly dismisses as ‘a bit of a con’.
He added: “It was fantastic to get the recognition for stroke but the whole CBE thing is a slightly antiquated system really.
“I see it more as a reflection of everyone’s hard work in stroke, who have done just as much or even more than me.”
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