§ Helen Jones
To ask the Secretary of State for Health (1) how many NHS trusts have developed integrated care pathways for stroke patients;
(2) how many stroke units have speech therapists working in that unit; and what proportion of their time was spent there in the last period for which figures are available. 
§ Dr. Ladyman
We do not routinely collect information on stroke services at the level of detail requested in these questions. The most comprehensive source of information on stroke is the National Sentinel Stroke Audit, carried out by the Royal College of Physicians. The audit was commissioned by the National Health Service in 1998 and was last updated in 2002. The results can be found at http://www. rcplondon.ac.uk/pubs/strokeaudit01–02.pdf. There will be a further update of these figures later this year.
Our major vehicle for improving standards for stroke services is through the older people's national service framework (NSF) which sets specific milestones for improvement by April 2004 of stroke services in primary care trusts, specialist services and general hospitals that care for people suffering from a stroke. Our document, Improvement, Expansion and Reform, which sets for the National Health Service a Priorities and Planning Framework for 2003–6, makes clear that implementation of the older people's NSF is a top priority, and that the 2004 milestone around specialist stroke services is a key target.
Implementation of the NSF for older people is leading to real improvements in stroke services and making a difference to people's lives. The development of better services and improved standards in stroke care requires the right balance between national standards, provided by the NSF, national clinical guidelines and local control. It will be important to ensure that stroke care services are co-ordinated and fully integrated within a full range of other relevant local services.