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Many areas of stroke care have gone backwards in past six years, stroke audit shows

New stroke statistics from the Sentinel Stroke National Audit Programme (SSNAP) show that the whole of the stroke care pathway is not available to many of the 1.3 million stroke survivors in England, Wales and Northern Ireland.

New stroke statistics from the Sentinel Stroke National Audit Programme (SSNAP) show that the whole of the stroke care pathway is not available to many of the 1.3 million stroke survivors in England, Wales and Northern Ireland.

SSNAP is a major national healthcare quality improvement programme based in the School of Life Course and Population Sciences at King’s College London. SSNAP measures the quality and organisation of stroke care in the NHS and is the single source of stroke data in England, Wales, and Northern Ireland.

The Stroke Association said that whilst there have been some improvements in stroke care such as decreases in in-hospital mortality and increased Early Supported Discharge (ESD), it is frustrating to see that progress is not mirrored across the rest of the stroke pathway. Alarmingly, in many areas treatment and care has stalled or even gone backwards in the last six years.

Many stroke survivors who feel abandoned after they leave hospital

Charlotte Nicholls, Head of Policy, said: “Progress in rolling out game-changing thrombectomy treatments has stagnated at around 2% – far below the 10% target set out in the NHS Long Term Plan for 2022.

“And whilst we welcome the expansion of ESD, this is only effective when stroke patients feel ready and are adequately supported into community rehabilitation. All too often we hear from stroke survivors who feel abandoned after they leave hospital, with care varying enormously and access to support a postcode lottery.”

She added that stroke survivors have complex ongoing needs relating to their mental and physical health following a stroke. But worryingly, few stroke survivors are getting ESD, vital community rehabilitation and psychological support, within the target referral times.

Just one third (33%) of community rehab teams meet treatment time targets and almost half (43%) have waits of 15 days or more. In addition, stroke survivors wait on average 10 weeks to see a psychologist. Many stroke survivors also do not receive a six-month review which is essential to assess their progress and identify their support needs.

“These excessive wait times and lack of follow-up, are putting stroke survivors’ crucial early recoveries at risk at a time they need support the most,” Charlotte said.

“The stark and wide nature of challenges that are threatening stroke survivors’ recoveries are exposed in these reports. We know that the Covid-19 pandemic has exacerbated existing system-wide pressures, but the improvements achieved in other parts of the system highlight the possibilities for advances.

“We urgently need to make sure stroke survivors get the support they need, regardless of where they have a stroke, so they can live their best lives possible. We want to see a renewed focus on delivering the priorities outlined in the NHS Long Term Plan and improving universal access to stroke prevention, treatment and high quality care.”

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