NHS pressures and inequalities in care ‘failing’ stroke patients, report says

NHS pressures and “deep inequalities in care” are “failing” stroke patients, according to a report.

The Stroke Association also warned that some patients face a “postcode lottery” for life-saving drugs and procedures.

It is calling for action from the Government, including the wider rollout of video technology that allows specialists to talk to ambulance teams to diagnose patients before they arrive at hospital.

The new report – Unlocking potential: a bold vision for stroke care in England – said long ambulance waits, handover delays and a lack of imaging capability for diagnostic testing are delaying patients’ access to specialist care and time-sensitive treatment.

It said 47% of patients were sent directly to a specialist stroke unit within four hours of arriving at hospital in 2023/24, down from 58% a decade earlier.

It added that “extra time spent waiting for specialist care dramatically increases the risk of long-term poor health and disabilities”.

The Stroke Association highlighted a “postcode lottery in access to treatment and rehabilitation”.

It estimated that 20% of stroke patients could benefit from thrombolysis, a drug that breaks down a clot and returns blood supply to the brain, which should be administered within four and a half hours of a stroke.

However, just 11.6% of patients received it in 2023/24.

It also said there is a “wide variation in rates of thrombolysis across the country” with 13.2% in the East of England compared with 10.1% in the Midlands.

There is also “significant regional variation” in thrombectomy – surgery to remove a blood clot which is often done after thrombolysis.

The report cited data from the Sentinel Stroke National Audit Programme, which estimates the current thrombectomy rate is 4.2%, although it is 10.3% in London compared with 1.1% in the east of England.

The association is also calling for the wider rollout of pre-hospital video triage (PVT), which allows stroke specialists to connect with ambulance teams to assess patients before they arrive at hospital.

The technology was piloted in 2020 and has since been trialled in 16 locations across England.

It comes as the Government said its 10-Year Health Plan will include three major shifts, including focusing on sickness prevention and a greater use of technology.

According to the Stroke Association, about 90% of strokes are preventable.

Juliet Bouverie, chief executive of the charity, said: “The 10-Year Health Plan is an extraordinary opportunity to transform healthcare and the many vital aspects which impact on the lives of stroke patients.

“Stroke rates keep rising, particularly among younger people, yet NHS pressures and deep inequalities in care across the country are failing patients.

“The Stroke Association supports thousands of patients and their loved ones every year, so we know first-hand the challenges that stroke survivors face due to the unfair and avoidable inequalities that continue to blight stroke care.

“Innovations such as PVT must be extended to ensure that every stroke survivor benefits from the incredible medical and digital advances we now have.”

The report calls for a fully funded prevention plan looking at risk factors for stroke, including regular blood pressure checks.

It also said there should be “universal 24/7 access” to treatments like thrombectomy and thrombolysis, as well as better community care for stroke survivors.

Ms Bouverie added: “Through clear steps in the 10-Year Health Plan, we’re calling on the Government to show the conviction and leadership needed to reset cardiovascular care and put it on a trajectory toward equity, innovation and excellence across the country.”

Professor Sir Stephen Powis, national medical director of NHS England, said: “Strokes are a leading cause of death and complex disabilities for adults in the UK, and the NHS is committed to helping people affected by this condition.

“As this report highlights, there is both the need and opportunity to improve stroke care in England.

“This includes supporting people to manage high-risk health conditions and improving access to lifesaving and disability-reducing innovations to improve the lives of stroke survivors across England.”

Labour MP Uma Kumaran, whose husband Jacob suffered a stroke in July last year, said: “My husband’s stroke was unexpected and a terrifying time for our family, but thanks to our quick action and the incredible care of NHS staff, he made a strong recovery.

“But not everyone is as fortunate as us. Stroke is the fourth leading cause of death in the UK, and too many patients miss out on life-saving treatment due to delays and underfunding.

“The Stroke Association’s work on this is vital. Their report is clear – innovative models and treatment plans can transform stroke care and save lives.”

A Department of Health and Social Care spokesperson added: “This government is taking action to tackle the biggest killers like heart disease and strokes.

“We have introduced health checks in workplaces and blood pressure checks on high streets to help catch illness earlier, and we are acting to prevent strokes in the first place by tackling smoking and obesity.

“We are committed to improving stroke prevention, treatment, and recovery through our 10-Year Health Plan, which will emphasise prevention and make better use of innovative technology like prehospital video triage (PVT) as we shift the NHS from analogue to digital.”