NHS stroke care declining not improving, charity warns

Thousands of stroke patients are missing out on lifechanging treatment as specialist, in-hospital care falls – while waiting times to get on a stroke ward soars, we can reveal. 

A year ago we launched our ‘Let Stroke Patients Thrive’ campaign, for better aftercare and access to miracle procedure thrombectomy to speedily remove clots so patients can return home that same day. 

But the Stroke Association claim despite the dedication of an overstretched workforce, the current NHS stroke care system still fails the 90,000 new survivors every year. 

Analysis of 2023-24 data by King’s College London’s Sentinel Stroke National Audit Programme (SSNAP) reveals rehab and thrombectomy are still being delivered erratically – with some acute stroke care basics worse than 10 years ago. 

The number of stroke patients directly admitted to a specialist unit within four hours of arrival at hospital was 46.7 per cent in 2023/24, but 54.9 per cent in 2019/20 and 58 per cent in 2013/14 – this dramatically increases the risk of survivors suffering long-term poor health and disabilities. 

Speedy treatment of stroke is crucial as 1.9 million brain cells die every minute that a stroke is left untreated, increasing the risk of serious long-term disability and even death. 

Meanwhile the number of patients spending over 90 per cent of their hospital stay on a specialist stroke unit has decreased in the last five years from 83.2 per cent in 2019/20 to 75.9 per cent in 2023/24 – a drop of over 4,400 patients. 

This specialist support is key to helping reduce mortality within the first 30 days and optimising stroke recovery. 

Juliet Bouverie OBE, Chief Executive of the Stroke Association, said: “Patients have been battling what feels like a permacrisis in our healthcare which has been blighting NHS care for long enough, 

“Governmental change is long overdue, and the 10 Year Health Plan is an ideal opportunity to ensure everyone who has a stroke can survive and live well.”

Hailed as a “miracle” medical procedure when first discovered two decades ago, a thrombectomy sees a stent passed up an artery or vein to drag out the blood clot causing the stroke. 

It is thought up to 10 per cent of UK stroke patients may be eligible for thrombectomy every year, more than 9,000 people – but sporadic availability means only 3.9 per cent accessed one last year. 

Since last year the Daily Express has been calling for a full, 24/7 thrombectomy access in the UK – after experts branded it currently “a postcode lottery”. 

With NHS England’s target at 10 per cent by 2027/28, the 3.9 per cent is way behind and there are continued regional disparities. 

Similarly, thrombolysis, a clot-busting drug, is underused. Around 20 per cent of stroke patients are eligible for the treatment but only an average of 11.6 per cent patients received the treatment in 2023/24 against the NHS England target of 20 per cent by 2025 to achieve the best performance in Europe.

The Stroke Association’s said the SSNAP data analysis happily shows there has been an increase in people receiving integrated community-based rehabilitation, which is the preferred option for patients, and a key factor in NHS reform. 

But the amount of time being spent delivering occupational therapy, physiotherapy and speech and language therapy has notably decreased over the last five years. 

Compounded by cuts to life-after-stroke support services, these types of care are vital to ensure stroke survivors can thrive throughout their recovery and beyond. 

Although there have been significant improvements in moving patient rehabilitation from the acute sector and into the community, such support is still falling well below the 2023 National Institute for Health and Care Excellence (NICE) guidelines. 

Meanwhile new NHS England figures reveal ambulance response times for Category 2 calls, which includes stroke, increased to 42 minutes and 15 seconds in October from 36 minutes and 2 seconds in September. 

This is above the 30-minute target set out in the NHS England Urgent and Emergency Care Plan and at a time when the NHS experienced more pressure in October than ever before on record. 

This is contributing to how people affected by stroke are taking longer to arrive at hospital from onset – the average time has increased by almost a third to nearly 250 minutes since 2013/14.

Now the Stroke Association is calling on the Government for the 10 Year Health Plan to invest in stroke prevention, such as regular blood pressure checks, so many of the 100,000 strokes which happen every year can be prevented. 

Also so support the delivery of universal 24/7 access to an acute stroke unit and stroke treatments, such as thrombectomy and thrombolysis. 

And lastly to support in-hospital and community rehabilitation services so that stroke survivors can live well after stroke.

NHS national medical director Professor Sir Stephen Powis told the Daily Express: “NHS staff are working hard to see and treat a huge rise in the number of people being admitted for strokes. 

“And while there is more to do, we have rolled out AI software to process brain scans faster and are increasing the number of patients receiving treatments like thrombectomy, thrombolysis and stroke rehabilitation. 

“We are also taking vital action to prevent strokes, with over a million blood pressure checks delivered in community pharmacies in the last year, and the rollout of new treatments for atrial fibrillation, which have benefitted hundreds of thousands of people at high-risk of stroke. 

“Any sign of a stroke is always an emergency, so it is vital that people call 999 immediately if they or someone else experiences a single symptom, whether it’s face or arm weakness or speech problems.”

Juliet Bouverie told us: “There has been a significant decline of in-hospital stroke care over the last 10 years, and this is of great concern to the Stroke Association.

“Despite a dedicated workforce with expert knowledge on how to help and support stroke survivors to make their fullest recoveries, the NHS stroke pathway has long been at crisis point.

“The recoveries of too many stroke survivors are being put at risk due to a lack of staff, spiralling waiting times and a lack of basic stroke care provision which compromises – rather than optimises – patient recovery.

“Patients have been battling what feels like a permacrisis in our healthcare which has been blighting NHS care for long enough. 

“Stroke was once seen as a condition with very little hope of survival and recovery. Now there are many game-changing treatments such as thrombectomy, which can make the difference between a stroke survivor walking and talking again or spending the rest of their lives with disabilities. 

“Thousands of stroke survivors are also not getting the care they need to aid recovery, such as rehabilitation or speech and language therapy. 

“The knock-on impact on health and social care costs are untenable as stroke survivors need long- term help. The personal cost also cannot be imagined as many stroke survivors contend with poor mental health. 

“The Government needs to bring about change for stroke survivors in the 10 Year Health Plan with increased funding for a dedicated NHS workforce to prioritise, rather than compromise, vital stroke care.” 

* The Stroke Association supports thousands of stroke survivors and their families by phone, at home, and in the community. Find out more at