Thousands of stroke patients to miss out on ‘miracle’ treatment

Roughly 47,000 stroke patients in England could miss out on a ‘miracle’ treatment unless the government invests in a 24/7 thrombectomy service, according to a new report.

Published by the Stroke Association, the report warns that there is currently a postcode lottery of stroke care, with 8% of stroke patients receiving thrombectomy in London, compared to 0-3% in other parts of the country.

What is a mechanical thrombectomy?

Mechanical thrombectomy (MT) is a procedure used to remove large stroke-causing blood clots from the brain via a catheter inserted into the patient’s groin.

Juliet Bouverie, Chief Executive of the Stroke Association describes it as a ‘miracle treatment’ that “pulls patients back from near-death and alleviates the worst effects of stroke.”

“It’s shocking that so many patients are missing out and being saddled with unnecessary disability. Plus, the lack of understanding from government, the NHS and local health leaders about the brain saving potential thrombectomy is putting lives at risk,” she added.

NHS England delivered mechanical thrombectomy to just 28% of all suitable patients in 2021

This year, NHS England missed its original target to make mechanical thrombectomy available to all patients for whom it would benefit – only delivering to 28% of all suitable patients by December 2021.

The report highlights staff shortages as a contributing factor, and estimates that the number of Interventional Neuroradiologists (INRs) in the workforce would have to double to make a 24/7 service viable. It also found:

• 52% of stroke units in England have a stroke consultant vacancy, which remain unfilled for an average of 18 months
• Only 46% of stroke units meet the minimum recommended staffing levels for senior nurses
• There are only 106 professionals who can perform thrombectomy in England (~4 per centre).

Calls for the government to invest £400 million in a 24/7 thrombectomy service

The Stroke Association is now calling on the government to invest £400 million in a 24/7 thrombectomy service, which could save the NHS up to £73 million per year. This will provide infrastructure, equipment, workforce training and support, targeting both thrombectomy centres and referring stroke units.

The Association is also urging the Department of Health and Social Care to develop a sustainable workforce plan to fill the gaps in qualified staff, and calling on NHS England to address challenges in transfer to and between hospitals in its upcoming Urgent & Emergency Care Plan.

“NHS England missed its target and it will miss this target again and again unless we see proper investment into making this happen. We have known for years that a thrombectomy service requires capital funding. This never came. We have seen lengthy vacancies lists for stroke clinicians. No plan was made to fill the gaps.

“Making capital funding available and having a proper workforce plan are the best places government and the NHS can start to make sure that everyone can have a thrombectomy when they need one,” said Ms Bouverie.

Number of thrombectomies in the UK remains much lower than elsewhere in Europe

The Association is also calling on the public to sign an open letter calling on UK Government to act on the recommendations set out in the Saving Brains report, and make thrombectomy available as soon as possible, 24 hours a day, 7 days a week, for everyone who needs it.

Prof. Martin James, Consultant Stroke Physician at the Royal Devon & Exeter Hospital and a Clinical Trustee of the Stroke Association, said: “Thrombectomy really is a game-changing treatment, yet the number of people receiving the treatment in the UK remains much lower than elsewhere in Europe, and has been only slowly increasing over recent years. At this rate, it won’t be available to all those who could benefit for many years to come.

“We need to ensure that thrombectomy is available to people with stroke wherever and whenever they need it, and that will require a big investment in people and equipment for the NHS. That sort of investment is long overdue and is urgently needed, and will change many lives for the better and save money.”