Commissioners and providers should ensure all patients with a suspected stroke are admitted as quickly as possible to an acute stroke unit.

The National Institute for Health and Clinical Excellence and the Royal College of Physicians made the recommendation yesterday as part of guidance to improve patient outcomes.

NICE specifies other new approaches to acute stroke and the management of mini-stroke, while the RCP has updated recommended procedures for recovery, rehabilitation, prevention and long term care and provided new advice on commissioning.

NICE predicts that implementing its advice in England will cost£2.8m a year through increased referrals, but will produce direct savings to the NHS of£2.7m. When wider "informal care savings" are included, the estimated saving is£5.3m. This is in addition to recommendations in the Department of Health's national stroke strategy, published last December.

Stroke Association director of communications Joe Korner said there were enough resources in place for the service to be able to admit all stroke patients to a specialist unit immediately, provided they were more efficiently used.

He said: "I believe the latest audit indicates there are probably as many beds as stroke patients, but they aren't organised properly into acute stroke units. The whole strategy and this guidance points to the need for hyper-acute stroke units."

Mr Korner said primary care trusts should commission across boundaries to ensure that a "critical mass" of patients and experts able to administer treatments such as thrombolysis was available.

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