When is a stroke unit not a stroke unit?

E vidence that stroke units save lives and reduce disability is now accepted. In some countries, including the United Kingdom, these findings have contributed to a government directive for all hospitals dealing with stroke to have had a dedicated stroke unit by April 2004. Despite the welcome strength of such political mandates, a number of crucial factors must be addressed if a real life stroke unit is to accomplish what research has shown to be possible. The most recent report on the National Sentinel Stroke Audit in this issue of QSHC raises some vital issues, not just for the UK where the number of hospitals with ‘‘stroke units’’ is relatively impressive (73% and counting as of February 2002), but also for other countries where there may be few, if any, units. If we fail explicitly to respond to these important findings, we should not be surprised when we fail to achieve outcomes we know to be possible.