HEREFORDSHIRE is in urgent need of a specialist stroke unit, but is unlikely to have one soon because of the lack of cash.

Important decisions will be taken in the next few months to decide what type of unit to have, where it will be and how much money it will cost.

But Paul Bates, chief executive of Herefordshire Primary Care Trust, said he was not optimistic that Government targets for a stroke unit by April this year could be met.

He thought the best the trust could do would be to come up with an agreed plan for the future and to implement it as soon as the money was available.

A health steering group of clinicians from both the PCT and Hereford Hospitals Trust will meet in March to consider the options.

Number one on the list is the establishment of a complete stroke unit at Hereford County Hospital, where patients would be treated on admission and then stay on to be helped with rehabilitation.

Another option could see patients being treated first at the County and then moved to a rehabilitation unit at Bromyard Community Hospital.

Others under consideration include the use of newly-opened Hillside House in Hereford for rehabilitation purposes or for this service to be carried out in patient's own homes.

If a decision can be reached it will then go to the boards of both trusts for consideration.

The urgent need for a stroke unit was highlighted in the annual report of Dr Mike Deakin, Herefordshire's director of public health.

It called for an urgent decision on a location for such a unit and rapid work to provide one.

His report said that, with a higher proportion of older people in Herefordshire than the national average, around 400 people a year were admitted to the County Hospital with stroke symptoms.

The hospital had a specialist stroke team but there was no designated specialist facility for the treatment of patients and no designated stroke consultant.

Dr Colin Jenkins is not a stroke consultant but looks after the interests of stroke patients at the County Hospital.

He told the Hereford Times that the present stroke service had improved since the move from the General Hospital but it was a limited service, with more specialists needed to help with rehabilitation.

Dr Deakin and Dr Jenkins have come up with the options for an improved service to be considered in March.

Mr Bates said everyone accepted that more had to be done for the stroke service in Herefordshire, but there were many financial pressures facing the health service.

They included the state of finances at the County Hospital and dealing with new contracts for GPs, consultants and health service staff. There were other local issues, such as dealing with the closure of two more hutted wards at the County.

"We know we want to establish a stroke unit and a better service. But there is no funding at the moment," he said.

"We must make sure we have an agreed policy in place so that we can include it in future plans and provide it as soon as money is available.''